F.A. Căruntu*, F.A. Căruntu – Jr.*
*Prof. dr. Florin Adrian Căruntu; dr. Florin Alexandru Căruntu-jr, asistent univ. Clinica a II-a de Boli Infecțioase Colentina. U.M .F. “Carol Davila”, București
Abstract
The first step in the pathogenesis of bacterial meningitis consists of the attachement and invasion of nasopharyngeal epitelium, bacteriemia and meningean invasion. The precocious antibiotherapy and the immunologic neutralisation of bacterial attachement may improve the prognosis. The next step is determined by the parietal components of destroyed bacteria. These trigger, directly or by macrophage activation, an overwhelmed systemic inflammatory reaction which damages the endothelium. Consequently appear a lot of disfunctions and serious lesions. These are not influenced by antibiothical therapy but may be improved by an adjuvant antiinflammatory therapy. It is possible to moderate the inflammation by using medicamentous or immunological neutralisation of endotoxin, citokines, activated cells etc. Ceftriaxone presents a lot of advanta ges: a broad spectrum of bactericidal activity, a good penetration into CSF, a long half-life and consequently can be administred once daily, shortens the duration of treatment and produces cost savings. The discontinous antibiotherapy, twice a day, medium doses penicillin/ampic illin, is very efficient and favourable.