Prior to initiating antimicrobial therapy in suspected bacterial meningitis, which action should be taken?

In suspected bacterial meningitis, it is crucial to obtain blood and cerebrospinal fluid samples before initiating antimicrobial therapy. This step is essential because it allows for the identification of the causative organism and helps guide appropriate treatment. The analysis of cerebrospinal fluid through lumbar puncture provides vital information regarding the presence of bacteria, white blood cell counts, and the levels of glucose and protein, which can help distinguish bacterial meningitis from viral causes or other types of meningitis.

Timely collection of these samples is particularly important, as starting antibiotics can alter the microbial landscape, making it more difficult to culture and identify the responsible pathogens. Effective management relies on early diagnosis and targeted therapy; therefore, the priority is to secure these samples before treatment begins.

Other actions, such as reducing fever or performing a Gram stain, may be clinically relevant but are secondary to the importance of obtaining the samples first. Waiting for drug susceptibility tests could delay necessary treatment and is not practical in the acute management of suspected bacterial meningitis.