Introduction: The aim of antimicrobial treatment of infections in the central nervous system (CNS) is to eradicate the bacterial cause. The choice of antibiotics should take into account its activity, pharmacokinetic properties, results of clinical trials, side effects and total treatment cost. Despite the fact that pharmacokinetics affects the ability of antibiotics to penetrate the blood brain barrier (BBB) significantly, the most important factor is that meningeal inflammation increases the permeability barrier. The selected antibiotic should have a bactericidal action and the achieved liquor concentration should be high above the minimal bactericidal concentration (MBC).
Antibiotic therapy: Empirical antibiotic therapy should be started immediate after taking the sample to make the etiological diagnosis, taking into account the patient ' age. previous diseases and immune status. The specific or targeted antibiotic treatment is carried out according to the microbiological sensitivity test of antimicrobial agents isolated. Whenever possible, the preference should be given to a monotherapy except when it comes to a cause requiring synergistic combination of antibiotics. The length of treatment is individually assessed and is mainly based on experience. Numerous studies have shown that it is possible to reduce inflammatory response in subarachnoid space and thus improve the outcome of meningitis by using anti-inflammatory agents, along with the antibiotics.
Conclusion: Today the increase in resistance to antibiotics is a leading medical problem in the 21st century. The most common micro organisms isolated from CSF (liquor) in our region are: Staphylococcus spp. coagulase negative. Haemophilus infuenzae, Neisseria meningitidis, serogroup B. Staphylococcus epidermidis, and Streptococcus beta haemoliticus. The resistance to antimicrobial drugs most frequently used in the treatment of bacterial meningitis is still not alarmingly. high in our country. Since there is a real possibility of development of high resistance in our area, the main recommendation is to rationalize the use of antibiotics.