Anecdotal experience suggested there were areas for improvement in meningitis management. To address this, we conducted a complete audit cycle of the management of meningitis in adult patients at Arrowe Park Hospital.


We utilised the abbreviated audit tool from the McGill et al 2016 meningitis guidelines.

Time period: 1/1/2017 to 31/12/2017. Cases audited: 20

A series of interventions were made.

Time period for second cycle: 1/2/2019 to 31/5/2019. Cases audited: 6


Audit standards were met for 1 out of 14 criteria for the first cycle and 2 out of 14 criteria for the second cycle.

Of note, there was reasonable compliance with empiric choice of antibiotic (80% à 83%), definitive choice of antimicrobials (95% à83%) and duration of antimicrobials (84% à 100%).

Improvements in investigations were seen in the second cycle:

1.Pneumococcal and Meningococcal EDTA PCR was sent (15% à 67%)

2.CSF glucose with concurrent plasma glucose sent (6.3% à 67%)

3.CSF for pneumococci and meningococci sent in all cases of suspected bacterial meningitis (22% à 67%)

The re-audit identified no improvement in the following areas:

1.Blood cultures taken within 1 h of arrival at hospital (30% à 33%)

2.LP performed within 1 h of arrival at hospital provided that it is safe to do so (0% à 0%)

3.Antibiotics started within 1 hr of arrival in hospital (35% à 33%)

In both audit cycles, 0% of patients were made aware of voluntary sector support.


Whilst improvements were achieved, there remains considerable scope for further improvement.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.

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