Meningitis is such a serious disease that without treatment it is almost 90% fatal, especially in the case of bacterial inflammation of the lining of the brain. Treatment of meningitis should be carried out only in a hospital setting, folk remedies can only be used as an addition that helps to better tolerate this condition, and they should only be used in consultation with the attending physician.
What is the treatment based on? Without the results of an analysis of CSF (cerebrospinal fluid) obtained by lumbar puncture, it is impossible to treat meningitis. Only this analysis can help the doctor to distinguish purulent meningitis from serous one, since according to clinical manifestations, that is, symptoms, this may not always be clear (accordingly, the treatment of meningitis will be incorrect). In addition, some diseases occur with both increased intracranial pressure and high temperature, and also have positive meningeal symptoms, so this manipulation is necessary for an accurate diagnosis.
During the puncture, a few milliliters of cerebrospinal fluid are taken for examination. One of them is sent for a clinical laboratory study, the results of which give a conclusion on how pronounced the inflammation is and whether it is serous or purulent in nature. Another small amount of cerebrospinal fluid is sent for virus and bacteriological studies, the result of which will come a little later and will help the doctor adjust the initially prescribed meningitis treatment.
Let's try to figure out what drugs are used to treat meningitis. Therapy of serous meningitis is based on the use of non-specific antiviral agents: these are mainly interferon preparations (Laferon, Viferon, Lipoferon). Their use is based on the fact that when any virus enters our body, the immune system responds with the production of a similar substance, which helps to cope with this infection. In addition, it is desirable to conduct a PCR study of cerebrospinal fluid for the DNA of herpes simplex viruses, varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus. It is these viruses that cause the most severe and disabling meningitis, but, fortunately, there is a special treatment against them: Acyclovir, Ganciclovir, Valaciclovir, plus a specific immunoglobulin. Sometimes, in case of a serious condition, with serous meningitis, treatment with intravenous Acyclovir is started before the results of PCR on the DNA of the herpes group viruses are obtained.
Treatment of meningitis in case of its tuberculous etiology consists in the introduction of several anti-tuberculosis antibiotics (for example, "Streptomycin") in larger dosages than withtuberculosis of another localization.
If serous meningitis is caused by HIV or AIDS-associated flora (it also has a serous character), treatment is carried out in specialized hospitals with specific drugs.
If the patient has purulent meningitis, treatment is with broad-spectrum antibiotics. Only those that can penetrate the barrier of cells surrounding the brain (blood-brain barrier) can be used. Such drugs are administered only parenterally (that is, intravenously or intramuscularly, but not in the form of tablets) and only in the maximum dosage.
The first antibiotic is selected based on the ratio between impaired consciousness and the level of inflammation in the liquor, age and comorbidities. So, if inflammation is expressed in thousands of cells, and the person is conscious, this disease was not a complication of pneumonia, otitis media, sinusitis or other ENT diseases, then Ceftriaxone and Amikacin in appropriate dosages can become the first antibiotics. More often, the disease requires more expensive drugs: Meronem, Vancomycin.
The second antibiotic, if necessary, is selected based on the results of sowing the cerebrospinal fluid on the microflora and the sensitivity of the pathogen to antibiotics. Treatment does not determine how severe meningitis symptoms are: therapy is selected solely on the basis of the results of a study of cerebrospinal fluid.
