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Initial therapy of bacterial meningitis with cefuroxime: Experience in 167 children

L Navas1, S M King, R Gold

  • 1Division of Infectious Disease, Department of Pediatrics, The Hospital for Sick Children; and Faculty of Medicine, University of Toronto, Toronto, Ontario.

The Canadian Journal of Infectious Diseases = Journal Canadien Des Maladies Infectieuses
|April 20, 2012
PubMed

Insights

Cefuroxime treatment for bacterial meningitis showed similar outcomes to ampicillin plus chloramphenicol, with no significant differences in mortality or neurological deficits. Hearing loss rates remained comparable between the two treatment groups.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Clinical Pharmacology

Background:

  • Bacterial meningitis remains a significant cause of childhood morbidity and mortality.
  • Previous treatment protocols involved ampicillin plus chloramphenicol.
  • The introduction of cefuroxime offered a potential alternative treatment.

Purpose of the Study:

  • To evaluate the morbidity and mortality associated with bacterial meningitis treated initially with cefuroxime.
  • To compare these outcomes with a historical cohort treated with ampicillin plus chloramphenicol.

Main Methods:

  • Retrospective chart review of microbiologically confirmed bacterial meningitis cases.
  • Study period: January 1984 to August 1988 at the Hospital for Sick Children, Toronto.
  • Comparison with a prospective study cohort from 1979-1983.

Main Results:

  • A total of 167 children were reviewed, aged six weeks to 17.1 years.
  • The case fatality rate was 7.8% and the hearing deficit rate was 13%.
  • No statistically significant differences were found in neurological outcome, hearing loss, or case fatality rates compared to the previous ampicillin/chloramphenicol cohort.

Conclusions:

  • Initial treatment with cefuroxime for bacterial meningitis yielded comparable results to ampicillin plus chloramphenicol.
  • The study did not demonstrate significant improvements in key patient outcomes.
  • A slight, non-significant increase in hearing loss was observed for Haemophilus influenzae type b meningitis.
Keywords:
Bacterial meningitisCefuroximePediatric

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