Emerging treatments

Glycerol

There is low-quality evidence to suggest the use of oral glycerol may have a small effect on reducing deafness in children, especially in Haemophilus influenzae type b meningitis.[149][150] Further studies are required to confirm these results. [ Cochrane Clinical Answers logo ] [Evidence B]

Conjugate vaccines targeting group B streptococcal infection

Group B streptococcus is the leading cause of meningitis and sepsis in neonates. Vaccines given to pregnant women may prevent group B streptococcus in newborns by transplacental antibody transfer.[151] Research is ongoing.

Conjugate vaccines targeting Neisseria meningitidis serogroup X

N meningitidis is a leading cause of bacterial meningitis and an important cause of severe epidemics globally, with six serogroups (A, B, C, W, X, and Y) responsible for over 95% of invasive meningococcal disease cases worldwide.[58]​ In the African meningitis belt, following the success of vaccination programs with serogroup A meningococcal conjugate vaccine, N meningitidis serogroups C, W, and X, and also Streptococcus pneumoniae have been identified as the main causative agents of more recent epidemics.[152] The Men5CV (NmCV-5) vaccine is a pentavalent vaccine targeted at meningococcal serotypes A, C, W, Y, and X. This vaccine is directed toward global control of meningococcal disease in the African meningitis belt and beyond, with demonstrated safety and effectiveness against a wider variety of serogroups including serogroup X.[153] The vaccine has demonstrated comparable immune response in phase 1 and 2 trials.[153][154]​​​ It has been recommended by the World Health Organization for incorporation into routine immunization programs in countries in the African meningitis belt, and Nigeria was the first country in the world to introduce roll out the vaccine.[58]​[155]​​ WHO: defeating meningitis by 2030: a global road map Opens in new window While the vaccine is available in Africa, it is not currently available in other countries as yet.

Invasive intracranial pressure (ICP) monitoring

One recent systematic review looked at the role of invasive ICP monitoring and ICP-based management in the treatment of acute bacterial meningitis. Overall the studies demonstrated enhanced patient outcomes in acute bacterial meningitis with the use of treatment strategies aiming to normalize ICP using continuous invasive monitoring and cerebrospinal fluid diversion techniques.[156]

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