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The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults

The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults
The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults

Bacterial meningitis and meningococcal sepsis are rare conditions with high case fatality rates. Early recognition and prompt treatment saves lives. In 1999 the British Infection Society produced a consensus statement for the management of immunocompetent adults with meningitis and meningococcal sepsis. Since 1999 there have been many changes. We therefore set out to produce revised guidelines which provide a standardised evidence-based approach to the management of acute community acquired meningitis and meningococcal sepsis in adults. A working party consisting of infectious diseases physicians, neurologists, acute physicians, intensivists, microbiologists, public health experts and patient group representatives was formed. Key questions were identified and the literature reviewed. All recommendations were graded and agreed upon by the working party. The guidelines, which for the first time include viral meningitis, are written in accordance with the AGREE 2 tool and recommendations graded according to the GRADE system. Main changes from the original statement include the indications for pre-hospital antibiotics, timing of the lumbar puncture and the indications for neuroimaging. The list of investigations has been updated and more emphasis is placed on molecular diagnosis. Approaches to both antibiotic and steroid therapy have been revised. Several recommendations have been given regarding the follow-up of patients.

Adult, Critical Care, Humans, Meningitis, Bacterial, Meningococcal Infections, Neisseria meningitidis, Sepsis, Spinal Puncture, United Kingdom, Journal Article, Practice Guideline, Research Support, Non-U.S. Gov't
0163-4453
405-438
McGill, F.
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Heyderman, R.S.
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Michael, B.D.
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Defres, S.
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Beeching, N.J.
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Borrow, R.
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Glennie, L.
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Gaillemin, O.
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Wyncoll, D.
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Kaczmarski, E.
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Nadel, S.
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Thwaites, G.
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Cohen, J.
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Davies, N.W.S.
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Miller, A.
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Rhodes, A.
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Read, R.C.
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Solomon, T.
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McGill, F.
2cc44e8f-1f7a-4f8d-950d-eff9ebb9ba31
Heyderman, R.S.
8f7afe4d-1758-4a08-84a2-fb61f21613ba
Michael, B.D.
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Defres, S.
e271110a-3310-41c2-ae36-a24f4624e53a
Beeching, N.J.
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Borrow, R.
ae200ab8-f9f3-49c6-a161-c8fc31d00a58
Glennie, L.
d5dacaf8-c47e-45ad-b5f8-2df088a082c6
Gaillemin, O.
e16c51cc-5ac9-4b8b-aa8b-3eea163bd243
Wyncoll, D.
17052831-9b87-4cd8-ac3e-941ef916473c
Kaczmarski, E.
7b10eda1-4f54-44be-8490-027fd58c2d2d
Nadel, S.
3504007b-b6c5-4716-a0a4-a4c5461753ba
Thwaites, G.
8f508844-f508-4eb9-b224-92109fe63709
Cohen, J.
6eddab3c-5a4d-458d-bcf9-c03812e057ea
Davies, N.W.S.
36ed4ead-0cb2-4638-b2f9-867bf4315b74
Miller, A.
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Rhodes, A.
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Read, R.C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Solomon, T.
ed09f985-18a3-42fc-86d0-61a5d2e59a95

McGill, F., Heyderman, R.S., Michael, B.D., Defres, S., Beeching, N.J., Borrow, R., Glennie, L., Gaillemin, O., Wyncoll, D., Kaczmarski, E., Nadel, S., Thwaites, G., Cohen, J., Davies, N.W.S., Miller, A., Rhodes, A., Read, R.C. and Solomon, T. (2016) The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. Journal of Infection, 72 (4), 405-438. (doi:10.1016/j.jinf.2016.01.007).

Record type: Article

Abstract

Bacterial meningitis and meningococcal sepsis are rare conditions with high case fatality rates. Early recognition and prompt treatment saves lives. In 1999 the British Infection Society produced a consensus statement for the management of immunocompetent adults with meningitis and meningococcal sepsis. Since 1999 there have been many changes. We therefore set out to produce revised guidelines which provide a standardised evidence-based approach to the management of acute community acquired meningitis and meningococcal sepsis in adults. A working party consisting of infectious diseases physicians, neurologists, acute physicians, intensivists, microbiologists, public health experts and patient group representatives was formed. Key questions were identified and the literature reviewed. All recommendations were graded and agreed upon by the working party. The guidelines, which for the first time include viral meningitis, are written in accordance with the AGREE 2 tool and recommendations graded according to the GRADE system. Main changes from the original statement include the indications for pre-hospital antibiotics, timing of the lumbar puncture and the indications for neuroimaging. The list of investigations has been updated and more emphasis is placed on molecular diagnosis. Approaches to both antibiotic and steroid therapy have been revised. Several recommendations have been given regarding the follow-up of patients.

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Accepted/In Press date: 23 January 2016
e-pub ahead of print date: 2 February 2016
Published date: April 2016
Additional Information: Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Keywords: Adult, Critical Care, Humans, Meningitis, Bacterial, Meningococcal Infections, Neisseria meningitidis, Sepsis, Spinal Puncture, United Kingdom, Journal Article, Practice Guideline, Research Support, Non-U.S. Gov't

Identifiers

Local EPrints ID: 417195
URI: https://eprints.soton.ac.uk/id/eprint/417195
ISSN: 0163-4453
PURE UUID: cef8798a-9815-4971-ad3f-3e634bc797cc
ORCID for R.C. Read: ORCID iD orcid.org/0000-0002-4297-6728

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Date deposited: 24 Jan 2018 17:30
Last modified: 03 Dec 2019 01:38

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