A Review of Pediatric Bacterial Meningitis

Amy M. Pick, PharmD, BCOP; Desirae C. Sweet, 2016 PharmD Candidate; Kimberley J. Begley, PharmD


US Pharmacist. 2016;41(5):41-46. 

In This Article

Abstract and Introduction


Pediatric bacterial meningitis is a medical emergency requiring immediate initiation of treatment. Although the United States and other developed countries have seen a decline in pediatric meningitis, bacterial meningitis continues to cause high morbidity and mortality globally. Vaccinations (Haemophilus influenzae type b, pneumococcal, and meningococcal) have significantly reduced the risk of bacterial meningitis in developed countries. The treatment of bacterial meningitis depends on the suspected or known causative organism. Treatment often incorporates a third-generation cephalosporin or penicillin plus vancomycin. Dexamethasone may be added to prevent neurologic sequelae such as hearing loss. Despite aggressive therapy, many patients will experience long-term neurologic complications.


Pediatric bacterial meningitis is a severe, life-threatening infection of the membranes (meninges) surrounding the brain and spinal cord. The infection may be associated with long-term, potentially devastating sequelae even when it is aggressively managed. Compared with viral meningitis, which frequently is self-limiting and has a good prognosis, bacterial meningitis carries a higher risk of morbidity and mortality. According to the CDC, 4,100 cases of bacterial meningitis were reported in the United States from 2003 to 2007, and approximately 500 deaths occurred annually during this period.[1] It is estimated that the peak incidence of bacterial meningitis occurs in children younger than 2 months of age and that at least 75% of cases occur in those younger than 5 years of age.[2–4]