Management of Adults With Bacterial Meningitis in the Emergency Department

Joshua Asemota; Iulia Stoian; Godson Amaze; Saheed Olayinka; Noel Uchenna; Mandar Marathe

doi:10.7759/cureus.62767

Original Research / Quality Improvement Emergency Medicine & Infectious Disease

Management of Adults With Bacterial Meningitis in the Emergency Department

Joshua Asemota, Iulia Stoian, Godson Amaze, Saheed Olayinka, Noel Uchenna, Mandar Marathe

Cureus, 16(6), e62767 · 2024 · doi:10.7759/cureus.62767

Cited by 5+ (per Google Scholar, Aug 2026 — check live count)

Plain-language summary

A quality-improvement audit at one of the UK's largest single-site emergency departments, checking how well national guidance for suspected bacterial meningitis — antibiotics within one hour — was actually being followed. A staff survey found only a quarter of prescribers knew the guideline existed, and a review of case notes found that just one patient out of thirty had received steroids within the crucial first hour, despite 92% of staff agreeing steroids mattered.

Why this matters

Bacterial meningitis is a medical emergency where treatment delay measurably worsens outcomes, yet this audit exposes a wide gap between guideline awareness and guideline delivery in a busy real-world department. The checklist intervention it proposes is a practical, exportable tool other emergency departments can adopt to close that gap.

Published abstract

Introduction: The Leicester Royal Infirmary Emergency Department is one of the largest single-site Emergency Departments in the UK. We evaluated the department's management of bacterial meningitis. The current national guideline recommends that all patients presenting with suspected bacterial meningitis receive antibiotics within one hour. Methods: A survey of 100 clinicians was performed to determine awareness of the guidelines, alongside a retrospective examination of case notes for patients presenting with suspected meningitis between May 2022 and May 2023. Results: Nine (25%) of prescribers knew of the guidelines, and six (16.7%) had utilised hospital guidelines. Thirty-three (91.7%) prescribers acknowledged the importance of steroids, but only seven (23%) of patients received this treatment, and only one (3.3%) within the first hour. Conclusion: Timely diagnosis and antibiotic therapy are pivotal in managing bacterial meningitis; a checklist was designed to facilitate effective management by increasing awareness of the guidelines.

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Keywords

bacterial meningitis antibiotics quality improvement emergency department guideline adherence

Cite this publication

Asemota J, Stoian I, Amaze G, Olayinka S, Uchenna N, Marathe M. Management of Adults With Bacterial Meningitis in the Emergency Department. Cureus. 2024;16(6):e62767. doi:10.7759/cureus.62767

Asemota, J., Stoian, I., Amaze, G., Olayinka, S., Uchenna, N., Marathe, M. (2024). Management of Adults With Bacterial Meningitis in the Emergency Department. Cureus, 16(6), e62767. https://doi.org/10.7759/cureus.62767

@article{AsemotaJ2024,
  author = {Joshua Asemota and Iulia Stoian and Godson Amaze and Saheed Olayinka and Noel Uchenna and Mandar Marathe},
  title = {Management of Adults With Bacterial Meningitis in the Emergency Department},
  journal = {Cureus},
  year = {2024},
  doi = {10.7759/cureus.62767},
  volume = {16},
  number = {6},
  pages = {e62767}
}

TY  - JOUR
AU  - Joshua Asemota
AU  - Iulia Stoian
AU  - Godson Amaze
AU  - Saheed Olayinka
AU  - Noel Uchenna
AU  - Mandar Marathe
PY  - 2024
TI  - Management of Adults With Bacterial Meningitis in the Emergency Department
JO  - Cureus
VL  - 16
IS  - 6
SP  - e62767
DO  - 10.7759/cureus.62767
UR  - https://doi.org/10.7759/cureus.62767
ER  -

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