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Acute bacterial meningitis in adults: a review of 493 episodes

Article Abstract:

A review of 493 cases of acute bacterial meningitis found 39% were acquired in the hospital, and the percentage had increased from 28% in the 1962-70 period to 48% in the 1980s. Gram-negative bacilli caused 33% of hospital-acquired cases compared with only 3% of community-acquired cases. Of the 296 cases of community-acquired meningitis, Streptococcus pneumoniae caused 37% of them, Neisseria meningitidis caused 13% and Listeria monocytogenes caused 10%. Altogether these bacteria caused only 8% of the hospital-acquired infections. Overall, 9% of the 445 patients had recurrent meningitis. Over the 27-year period for which medical records were examined, the death rate remained a fairly constant 25%. Death from community-acquired meningitis was associated with older age, confused or unresponsive mental state and seizures within the first 24 hours of hospital admission.

Author: Calderwood, Stephen B., Swartz, Morton N., Weber, David J., Caviness, Verne S., Jr., Durand, Marlene L., Miller, Samuel I., Southwick, Frederick S.
Publisher: Massachusetts Medical Society
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1993
Development and progression, Meningitis

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Use of antimicrobial agents and drug resistance

Article Abstract:

It is very clear that the inappropriate use of antibiotics is partially responsible for the emergence of drug resistance in bacteria. This occurs because the antibiotic kills off the susceptible bacteria while the resistant bacteria survive. Some bacteria have acquired resistance to many antibiotics. A 1997 report found that a national policy in Finland to reduce the use of erythromycin led to a drop in the percentage of bacterial isolates that were resistant to erythromycin. Other studies have confirmed that a judicious policy of antibiotic use can lower resistance rates.

Author: Swartz, Morton N.
Publisher: Massachusetts Medical Society
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1997
Editorial, Usage, Antibiotics, Causes of, Drug resistance in microorganisms, Microbial drug resistance

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Recognition and management of anthrax -- an update

Article Abstract:

The symptoms, diagnosis, treatment and prevention of anthrax in humans is reviewed. Anthrax normally occurs in people who are exposed to affected animals but it can also be used as a biological weapon. It can be inhaled, swallowed, or come in contact with skin.

Author: Swartz, Morton N.
Publisher: Massachusetts Medical Society
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2001
Care and treatment, Anthrax

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