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Slide 25 Most textbooks recommend restriction of fluids due to the possibility of inappropriate secretion of anti-diurettic hormone but there is little evidence that this condition exists in all cases of bacterial meningitis. More important is to maintain adequate maintenance fluids because of the possibility of dehydration due to fever or poor appetite. Monitoring of output and electrolytes must be performed to watch out for the possibility of SIADH. Also nutritional support should not be neglected. Preventive measures such as chemoprophylaxis for specific pathogens, vaccinations and infection control is important but beyond the scope of this lecture.

Slide 26 In conclusion, management of infectious diseases is constantly changing because of new discoveries in management and the emergence of resistant bacteria. Conditions in certain areas may be different and guidelines made in one country is not necessarily applicable in other settings due to difference in susceptibility patterns and resources available. Thus local data is essential to provide a rational approach to the management of bacterial meningitis in children.

Slide 27 It is imperative to acknowledge the members of the teams which made these recommendations. As conditions change, revisions shall be made and updates are forthcoming.

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