If your doctor suspects you have meningitis, he or she will likely put you on a round of broad-spectrum antibiotics to fight potential nonviral types of infectious meningitis. Once the type of meningitis has been determined — viral, bacterial, fungal, or noninfectious — your doctor will provide a more specific treatment.
How Is Viral Meningitis Treated?
Antibiotics cannot kill viruses, and using antibiotics when there is no bacterial infection can have harmful effects, such as developing antibiotic resistance. If you have viral meningitis, you will be taken off whatever antibiotic therapy you may have been initially given. There is no specific treatment for viral meningitis, which is often mild. Most of the time, people recover from viral meningitis in 7 to 10 days with little more than rest, over-the-counter fever reducers or pain medication, and proper fluid intake. But if you have meningitis caused by a herpes virus or influenza, your doctor may prescribe an antiviral medication, such as:
ganciclovir (Cytovene) or foscarnet (Foscavir), which are sometimes used to treat cytomegalovirus meningitis (CMV meningitis) in people with weakened immune systemsacyclovir (Zovirax), which may be used to treat meningitis from the herpes simplex virus
How Is Bacterial Meningitis Treated?
If you have bacterial meningitis, you will be treated with one or more antibiotics that target the bacteria causing your infection. These antibiotics commonly include:
Cephalosporin antibiotics, such as cefotaxime (Claforan) and ceftriaxone (Rocephin), for Streptococcus pneumoniae, Neisseria meningitidis, and ampicillin-resistant Haemophilus influenza type B (Hib) meningitisampicillin (Omnipen) (a penicillin-class drug), for Haemophilus influenzae type B and Listeria monocytogenesvancomycin (Firvanq) (delivered intravenously) for meningitis caused by several different types of bacteria strains
A number of other antibiotics may also be used, such as:
meropenem (Merrem)The aminoglycoside antibiotics tobramycin (Tobi) and gentamicin (Garamycin)ciprofloxacin (Cipro) and rifampin (Rifadin), which are sometimes given to family members of people with bacterial meningitis to help protect them from catching the infections
Other Meningitis Treatments
Fungal meningitis is treated with long courses of high-dose intravenous (IV) antifungal drugs. These medicines are often part of the azole class of antifungal drugs, such as fluconazole (Diflucan), which is used to treat infections from Candida albicans, the fungus behind yeast infections. Depending on the type of infection, other antifungals may also be used. For example, amphotericin B (AmBisome) is one of the most common treatments for cryptococcal meningitis, caused by the fungus Cryptococcus neoformans. Amphotericin B may also be used to treat a rare type of parasitic meningitis caused by Naegleria fowleri. Alternatively, the antifungal agent miconazole (Buccal) and the antibiotic rifampin may be used. In addition to the above drugs, corticosteroids may be used to reduce meningitis inflammation. This is especially important in bacterial meningitis; for this reason, steroids are often given in conjunction with antibiotics.
Can You Get a Vaccine to Prevent Meningitis?
Vaccines cannot protect you from the noninfectious causes of meningitis, which include:
CancerAutoimmune disordersCertain drugs
But meningitis vaccines can protect you from the three most common bacteria that cause the disease in children and adults — Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae type b (Hib) — and certain meningitis-causing viruses. RELATED: 10 Ways to Ease Your Baby’s Vaccination Pain
What Are the Vaccines for Meningococcal Meningitis?
Meningococcal disease is any illness caused by the bacterium N. meningitidis. At least 12 different serogroups, or strains, of N. meningitidis have been identified so far, with five of them (A, B, C, W-135, and Y) causing the majority of meningococcal disease cases in the world. (1) Menomune, an older vaccine that protected against these four strains, was discontinued in February 2017. The two available meningococcal conjugate vaccines that protect against strains A, C, W-135, and Y are:
MenactraMenveo
The Centers for Disease Control and Prevention (CDC) recommends that all children ages 11 and 12 receive one of these vaccines, followed by a booster shot at age 16. (2) These vaccines are also recommended for babies, children, and adults at particular risk for meningococcal meningitis. No booster shot is needed if the vaccine is given for the first time at age 16 or older. The Food and Drug Administration (FDA) recently approved the first two vaccines for N. meningitis group B for people between ages 10 and 25. They are:
TrumenbaBexsero
What Are the Vaccines for Pneumococcal Meningitis?
Approved in 2010, the pneumococcal conjugate vaccine (PCV13 or Prevnar 13) protects against 13 strains of pneumococcal bacteria. It’s recommended for all infants and young children, and for adults older than 65. The pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax), approved in 1983, protects against 23 strains of pneumococcal bacteria. It’s recommended for all adults age 65 and older and everyone older than age 2 with a high risk of pneumococcal disease due to health issues or medications they take. RELATED: Pneumonia Resource Center: 10 Terms You Should Know
What Are the Vaccines for Haemophilus Pneumoniae Type B (Hib)?
Four Hib vaccines are available. Depending on the brand, they’re given in two doses (PedvaxHIB) or four doses (like Pentacel). They’re recommended for all U.S. children under age 5, and the first dose is usually given when a child is 2 months old. (3)
What Are the Vaccines for Viral Meningitis?
No vaccines are available to protect against non-polio enteroviruses, by far the most common cause of viral meningitis. But vaccines can prevent other meningitis-causing viruses, including mumps, measles, influenza, and chickenpox (varicella). The measles, mumps, rubella, and varicella (MMRV) vaccine, approved in 2005, protects against four meningitis-causing viruses. Separate MMR and varicella vaccines are also available. The vaccines are recommended for all children between 12 months and 12 years old, with the first of two shots given between ages 12 and 15 months, and the second given between ages 4 and 6 years. The CDC recommends that everyone older than 6 months get a flu vaccine every flu season. (4) Routine shots of the flu vaccine are necessary because the formulation of the vaccine is updated yearly to account for the ever-mutating flu viruses. Additional reporting by Carlene Bauer.