[Bacterial meningitis: factors related to the delay before appropriate antibiotic administration in the emergency department].

Med Mal Infect

Urgences médico-chirurgicales adultes (UMCA), CHU Pontchaillou, 35033 Rennes cedex, France.

Published: June 2013

AI Article Synopsis

  • The study aimed to evaluate the alignment of medical practices with French guidelines for treating acute bacterial meningitis (ABM) and to identify factors contributing to delays in appropriate treatment.
  • Data was collected retrospectively from 31 adult patients with ABM, revealing that a high percentage received the recommended antibiotics, but there were notable delays in treatment initiation and procedures like lumbar puncture.
  • Notably, including a suspicion of ABM in the admission letter was linked to improved timeliness in both lumbar puncture and antibiotic therapy, suggesting that proper documentation can enhance emergency care management.

Article Abstract

Objectives: We had for aim to check the appropriateness of our practices according to French guidelines (17th consensus conference, SPILF 2008) and to identify variables associated with the delay before appropriate measures were implemented.

Methods: Our retrospective observational study (2009-2011) focused on acute bacterial meningitis (ABM) in adults. Data was collected on a standardized questionnaire from medical charts and nurse reports.

Results: We included 31 adults presenting with ABM; 29 (93.5%) received ceftriaxone or cefotaxime in the emergency department. Indications for corticosteroids and brain imaging complied with guidelines in respectively 71.0% and 83.9% of cases. The median delays (IQR) were: admission/lumbar puncture (LP), 2h43 [1h09-5h57]; admission/antimicrobials, 3h21 [1h34-5h11]. The indication of suspected ABM in the admission letter was associated with earlier LP (P=0.01), and was almost significantly associated also with faster initiation of adequate antibiotic therapy (P=0.05).

Conclusions: Suspicion of ABM mentioned in the admission letter was associated to a better management in the emergency department.

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http://dx.doi.org/10.1016/j.medmal.2013.05.009DOI Listing

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