Experts at St George’s University of London, in a study funded by the charity Meningitis Research Foundation, identified a range of concerning issues, including a lack of recognition of the symptoms and signs by GPs and in hospital; delays in starting antibiotics; choice of antibiotics not following NICE guidelines; and delays in performing lumbar puncture, which is essential for correct diagnosis of bacterial meningitis.
Another key issue was that post hospital admission management was inadequate in some cases, for example, in obtaining hearing tests or ensuring follow-up in clinic.
Professor Paul Heath, senior author of the paper, said: “Our study highlighted the difficulties in diagnosing this condition as well as variations in treatment across the UK. It is clear that better recognition and management is essential if lives are to be saved and complications of meningitis minimised.”
Vinny Smith, Chief Executive of Meningitis Research Foundation (MRF) said: “Young infants are at higher risk of life threatening meningitis than any other age group. This study highlights why it is so difficult for parents and health professionals alike to recognise the non-specific symptoms in young infants with bacterial meningitis and we are working with the experts St George’s University of London to address that.”
The study recommends a targeted campaign for education and harmonisation of practice. As a result MRF has collaborated with the study investigators and RCPCH to create a teaching package aimed at doctors and healthcare professionals to promote best practice.
The package includes an eTool to help clinicians recognise clinical features of bacterial meningitis in young infants; a lumbar puncture information sheet to help doctors explain this procedure to parents; and an algorithm to aid management of bacterial meningitis. The eTool is available at: neonatal.meningitis.org
neonatal.meningitis.orgVinny Smith added: “The educational package has been piloted by paediatricians and we hope that it can ultimately improve outcomes for this vulnerable age group.”
The research paper, “Assessment of healthcare delivery in the early management of bacterial meningitis in UK young infants: An observational study” is published in BMJ Open.
“Assessment of healthcare delivery in the early management of bacterial meningitis in UK young infants: An observational study”