Can meningitis be treated with oral antibiotics?

Are you feeling a little feverish? Are the chills running down your spine like a Hollywood horror movie? Perhaps, it’s not just the winter cold that has got you bedridden. It could be meningitis!

Meningitis is an infection of the thin tissue surrounding the brain and spinal cord, also known as meninges. Although viral meningitis can resolve on its own without treatment, bacterial meningitis requires urgent medical attention (no kidding). But do antibiotics necessarily mean intravenous injections? Can oral antibiotics fight off this nasty bug too?

Let’s Get into Some Definitions First!

Before we go any further into treatments for meningitis let’s first get some definitions straight so that everyone is clear about what we are talking about.

  • Oral: Medications taken by mouth.
  • Intravenous (IV): Medications given through a vein using a needle or catheter.
  • Antibiotic: A medicine that kills bacteria or prevents their growth.

Now onwards to treating bacterial meningitis…

The Usual Suspects

Penicillin was one of the earliest and most popular antibiotics used to treat bacterial meningitis. However, due to increasing antibiotic resistance penicillin became less effective over time. In response to this problem several other antibiotics were developed (science FTW) including ampicillin, cefotaxime and ceftriaxone commonly used today. These medications have had great success in treating severe cases when administered intravenously.

So why not just administer these intravenously and call it day? Why consider any other ways of administration such as orally?

Pros & Cons Of IV Administration

There are several advantages / disadvantages in administering medication through an IV including:

Advantages

  • High concentrations delivered directly into bloodstream delivering faster results
  • Allows for precise dosing control

Disadvantages

  • Expensive and requires trained personnel to administer
  • Can cause irritation and potential system infection

So, when considering oral administration the advantages include:

Advantages

  • Highly accepted by patients (let’s face it, who wants needles)
  • Inexpensive comparing intravenous medication

However, there are also disadvantages such as:

Disadvantages

  • Less precise dosing control compared with IV administrations.
    (Fun fact: only about half of a tablet dose is released into blood plasma).

What Does The Science Say?

Antibiotics for bacterial meningitis can be categorized either in their effect on pneumococcus or on meningococcus types. This categorization depends upon the bacteria that has caused the disease.

One study found that treating severe cases of meningitis effectively relied heavily upon using broad-spectrum antibiotics like ampicillin/sulbactam combined with gentamicin. On average these medications were administrated for around two weeks through an IV (needle-phobics beware) but generated impressive results.

Another public health review carried out by National Institutes of Health was even more conclusive saying, “β-lactams are preferred over aminoglycosides because β-lactams have been shown to also inhibit cytokine release induced by exposed lipopolysaccharide.”

This long scientific phrase simply means beta lactum drugs not only destroy bacteria cell walls but help prevent inflammation too – double whammy! Minimizing cytokine production reduces damage caused by invading pathogens which reduce complications associated with long-term care needed for recovery from this illness.

But here’s the kicker!

Studies conducted at Newcastle University indicate certain penicillin treatments may possibly be safely administered orally! Sounds interesting right? Let’s dig further…

A research team led by Dr. Victoria Miiller from Newcastle University’s Institute of Cellular Medicine discovered some forms of penicillins were easily absorbed, reaching therapeutic levels in the cerebrospinal fluid (oh my). This is important because when bacterial meningitis progress to higher stages it causes inflammation within and around the brain. With IV medication there is no restriction on how much of drug can pass though blood-brain barrier disturbing normal functioning of organ. That’s where oral administration steps up as a possible safer method!

But Don’t Take Our Word For It!

Clinical trials with small sample sizes have conducted research upon oral administration practices which unremarkably adopted moderate success yet nowhere as powerful results from intravenous methods.

Even Prominenix Biotherapeutics – a US based pharmaceutical company has stepped into ring developing vaccines eliminating need for needles altogether. Recently completing phase 2 clinical testing its vaccine candidate is highly similar to penicillin-based drugs for treatment.

Overall, antibiotics administered intravenously are still preferred over orally despite new findings providing simpler more patient-amiable approach fighting against infectious diseases such as meningitis (IV treatments not looking soo bad now huh!).

In conclusion if you do suddenly start feeling ill then go seek medical advice straight away just so you know what road you’re going down! Stay healthy friends 😉

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