Clinical Audit on Management of Suspected Meningoencephalitis Patients at Lady Reading Hospital, Peshawar

Background: Meningoencephalitis is a life-threatening neurological emergency requiring rapid diagnosis and prompt initiation of treatment. Clinical audits are essential tools for assessing and improving adherence to evidence-based management protocols, particularly in resource-limited settings. Objective: To evaluate the management of suspected meningoencephalitis patients and assess improvement in clinical practices following the implementation of recommendations from the first audit cycle. Methods: This second-cycle clinical audit was done in the Department of Internal Medicine, Lady Reading Hospital between January and December 2025. They included 150 adult patients suspected of meningoencephalitis. A structured proforma was used to gather data that were analyzed by SPSS version 25. The main indicators were the time of empirical therapy, the utilization of a lumbar puncture, the use of neuroimaging, and the compliance with clinical guidelines. Results: Marked improvements were seen in the second audit cycle. Empirical antibiotics began sooner, 52 to 70, lumbar puncture rates rose to 73, and compliance with investigation protocols upsurged to 76. There was also an increase in documentation practices by 60 to 80. Nevertheless, the loopholes persisted in terms of consistency and adherence to antiviral therapy and guideline universality. Conclusion: As evidenced in the audit, structured clinical audits play a significant role in improving the management of suspected meningoencephalitis. We should continue monitoring and make some specific interventions to attain ideal levels of care and enhance patient outcomes.

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