Bacterial meningitis is a severe infectious disease of the membranes lining the brain resulting in a high mortality and morbidity throughout the world. In the past decades the epidemiology and treatment strategies for community-acquired bacterial meningitis have significantly changed [1],[2],[3]. First, the introduction of conjugate vaccines in Europe resulted in the virtual disappearance of Haemophilus influenzae type b, while conjugate pneumococcal and meningococcal vaccines have substantially reduced the burden of bacterial meningitis [1]. As a result, community-acquired bacterial meningitis has become a disease that currently affects more adults than infants, with its specific complications and treatment options. A second important development is the increasing rate of reduced susceptibility to common antimicrobial agents among strains of Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus). Large differences in resistance rates in Europe exist, and empiric antibiotic treatment needs to be adjusted according to regional epidemiology. Finally, several adjunctive treatments have been tested in randomized controlled trials, often with conflicting results [3]. These developments leave the physician in need of a clear practical guideline, summarizing the available evidence for diagnostic methods, and antimicrobial and adjunctive treatment in bacterial meningitis. To this end the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) promotes guidelines development in the field of infectious diseases. This guideline project was initiated by the ESCMID Study Group for Infections of the Brain (ESGIB).