Researchers from the Cochin Institute have discovered how to boost antibiotic treatment against bacterial meningitis: use antipsychotics.
Relatively unknown to the general public, meningitis is an inflammation of the meninges (envelopes of the spinal cord and brain in which cerebrospinal fluid circulates). There are two forms, the viral, benign, and the bacterial, much more serious. While most patients with this form of meningitis recover with antibiotics, when left untreated, it can cause serious complications (deafness, brain damage, epilepsy, mental retardation, etc.) and in 50% lead to quick and brutal death.
Today, French researchers have found how to strengthen the treatment against this disease. According to their study published in the journal Nature Microbiologyantipsychotic drugs could be widely used to boost the effectiveness of antibiotics already in use.
Phenothiazines
Scientists from the Cochin Institute administered phenothiazines, from the family of antipsychotics, to mice suffering from bacterial meningitis. Within minutes, the drugs disabled the bacteria’s long, sticky arms. Without these appendages, it can no longer move, clump together or cling to blood vessels as easily.
Antipsychotics “reduce meningococcal colonization of human vessels and prevent the vascular dysfunction, intravascular coagulation and overwhelming inflammation that characterize invasive meningococcal infections. Finally, they reduce lethality,” the study authors state. Moreover, “if given at the start of the infection, it reduces vascular lesions and improves the survival rate of mice that have not received antibiotic treatment”.
Few side effects, say researchers
In detail, antipsychotics weaken the infection but do not kill it. This is where antibiotics still have a role to play: if conventional antibiotics are used with antipsychotics, their effectiveness will be much better, says the study. Thus, the antipsychotics could disrupt the existing clumps of the bacteria in humans and the antibiotics would then take care of killing the infection.
As for those who are worried about possible dependence or otherwise on antipsychotics, “it’s therapeutically safe with few side effects when used in moderation. It’s been seen for the 60+ years that these drugs are used,” the authors say. While further trials are yet to take place, the Cochin researchers are hopeful that their findings may eventually lead to a more effective treatment in humans.
Knowing how to diagnose meningitis correctly and in time, a real challenge
In about 70% of cases, bacterial meningitis occurs in early childhood, before the age of 5 years. In adults, it is triggered in people who have been in contact with a patient, have a neurosurgical history or are immunocompromised (diabetes, alcoholism, HIV, etc.) according to the World Health Organization (WHO).
Generally, the patient suffers from high fever, delirium, migraines and vomiting. One of the most serious forms of bacterial meningitis is meningococcal septicemia. The latter is characterized by a hemorrhagic eruption and rapid circulatory collapse. Even when diagnosed early and adequate treatment instituted, 8-15% of patients die, often within 24-48 hours of the onset of symptoms. And if left untreated, meningococcal meningitis is fatal in 50% of cases. It can also lead to brain damage, hearing loss or disability in 10-20% of survivors.
But whether bacterial or viral, the dangerousness of meningitis is due to the fact that it is often misdiagnosed or too late. According to a British study carried out last summer, out of 1000 patients followed, in 43% of cases, the virus or bacteria responsible for the disease had not been identified. However, according to the researchers, “rapid diagnosis of a specific cause of meningitis is essential to prescribe the right antibiotics if necessary, or avoid unnecessary antibiotics in patients with viral meningitis. Efforts should focus on treatment symptoms and speed up discharge from hospital, which would be less painful for patients”.
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