Global Bacterial Meningitis Guidelines: from Policy to Action

Luisa F Alviz; Rodrigo Hasbun; Kiran T Thakur;

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ABSTRACT

Bacterial meningitis remains a leading cause of preventable mortality and long-term neurological disability worldwide, despite the availability of effective diagnostics, antimicrobials, and vaccines. Historically, management has relied on regional and disease-specific recommendations that varied in scope and lacked global adaptability across diagnosis, treatment, and long-term care. The 2025 World Health Organization (WHO) Global Guidelines on Meningitis Diagnosis, Treatment, and Care represent the first comprehensive effort to harmonize management across diverse health system contexts. This review synthesizes how this global policy recommendations can be translated into clinical and public health action, particularly in resource-limited and outbreak-prone settings. Emerging literature emphasizes the need to standardize management algorithms and expand the focus beyond acute treatment, recognizing meningitis as a condition with long-term functional and quality-of-life consequences that require structured follow-up evaluations. Persistent implementation barriers are also highlighted, including limited diagnostic capacity, inconsistent antimicrobial access, workforce constraints, and systemic inequities that disproportionately affect low- and middle-income countries. The WHO guidelines provide a unified clinical and policy framework spanning prevention, acute management, and long-term care. Their impact will depend on effective implementation, health system strengthening, and research supporting context-adapted strategies to reduce global meningitis mortality and disability.

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