Assessment of adherence to the Infectious Diseases Society of America guidelines for treating suspected meningitis in adults: a retrospective observational study

Abstract Objectives This study aimed to assess physicians’ adherence to the Infectious Diseases Society of America (IDSA) guidelines in managing and treating adult patients (≥ 18 years old) admitted with suspected cases of meningitis and to investigate any associations between guideline adherence and hospital length of stay (LOS) as well as all-cause mortality among these patients. Methods This retrospective observational study was conducted at a tertiary care hospital in Jordan, focussing on adult patients admitted with suspected meningitis between 1 January 2019 and 30 September 2022. The study aimed to assess the appropriateness of antibiotic prescriptions before culture results according to IDSA guidelines and calculate the overall adherence rate. Additionally, the study observed hospital LOS and all-cause mortality among the enrolled patients. Key findings Of the enrolled adult patients (n = 118), 14.4% (n = 17) were diagnosed with bacterial meningitis. Notably, only five patients (4.2%) were treated appropriately, adhering entirely to the IDSA guidelines, whereas the remaining 95.8% (n = 113) showed various forms of non-adherence to these recommendations. The highest adherence to IDSA recommendations was observed in performing cerebrospinal fluid culture (100%), whereas the lowest adherence was noted in selecting appropriate doses and durations for the empiric antibiotics (n = 18, 26.5% and n = 21, 30.9%, respectively). No significant associations were found between adherence to IDSA treatment guidelines and hospital LOS (P = .100) or all-cause mortality (P = .332) among these patients. Conclusion This study revealed low overall adherence to IDSA guidelines among adult patients. Key areas for improvement in management include promptly selecting appropriate empiric antibiotics with correct dosing and duration to mitigate adverse effects and prevent bacterial resistance.