Treatment of bacterial meningitiS
Measure Purpose: Ensure the rapid diagnosis and treatment of bacterial meningitis
The numerator: Patients >21 years of age where dexamethasone 10mg is given intravenously before or with the first dose of antibiotics in suspected acute bacterial meningitis
is divided by
The denominator: Patient with suspected acute bacterial meningitis
Exclusions are removed from the denominator for:
- History of hypersensitivity to corticosteroids
- Treated with oral or parenteral antibiotics in the previous 48 hours
- Recent history of head trauma, neurosurgery
- CSF shunt
Key Phrases
Key phrases you should document to meet the measure include:
- Suspected acute bacterial meningitis
- Dexamethasone 10mg given intravenously with first dose of antibiotics
- Dexamethasone 10mg given intravenously before first dose of antibiotics
Measure Calculation Example
Dr. Williams had 200 patients between January 1 and December 31 of the measurement year. 16 of them presented to the emergency department and 9 were admitted to the hospital. 15 of those 200 patients were suspected of having bacterial meningitis.
Of the 15 patients with suspected bacterial meningitis, 2 had been treated with oral or parenteral antibiotics in the previous 48 hours, and 1 had a hypersensitivity to corticosteroids. These three patients are excluded from being counted in the denominator.
Of the now 12 patients that still qualify for this measure, 5 patients had 10mg of dexamethasone given intravenously with the first dose of antibiotics, and 1 patient had 10mg of dexamethasone given intravenously before the first dose of antibiotics.
Quality of patient care = 6/(15-3). Dr. Williams has a score of 50% for this measure.