Review of Progress and Challenges in Bacterial Meningitis—Reply.

Comment & Response B In Reply b In response to the Review article on bacterial meningitis,[1] Dr Ait-Ali and colleagues describe the usefulness of the I S pneumoniae i ICT that can be performed on CSF of patients with suspected pneumococcal meningitis.[2] I agree that this is a very sensitive and specific test for pneumococcal meningitis, and is particularly useful in hospitals without access to multiplex PCR assays. Meningitis guidelines have recommended adding rifampin, especially in the setting of penicillin-resistant or cephalosporin-resistant pneumococcal meningitis, but this recommendation mostly comes from in vivo studies and case reports.[6] To my knowledge, there are no randomized clinical trials showing that adding rifampin decreases mortality in bacterial meningitis. I agree that further studies are needed to clarify the role of nonbacteriolytic antibiotics, including rifampin, or other antibiotics such as ceftaroline, linezolid, and quinolones, with the aim of improving outcomes in patients with bacterial meningitis. [Extracted from the article]