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Ceftriaxone monotherapy for bacterial meningitis in children
H M Grubbauer1, H J Dornbusch, P Dittrich
1Department of Pediatrics, University of Graz, Austria.
Chemotherapy
|January 1, 1990
Summary
Ceftriaxone (CTR) effectively treated bacterial meningitis in children, achieving sterile cerebrospinal fluid cultures and high drug levels. While side effects occurred, CTR is a safe and effective option for daily pediatric meningitis treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Bacterial meningitis remains a significant cause of childhood morbidity and mortality.
- Effective antibiotic therapy with good cerebrospinal fluid penetration is crucial for treatment outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of single daily dosing of ceftriaxone (CTR) in pediatric patients with bacterial meningitis.
- To assess cerebrospinal fluid (CSF) drug concentrations and clinical outcomes.
Main Methods:
- A total of 33 pediatric patients with bacterial meningitis received intravenous ceftriaxone (100 mg/kg/day) for a median of 13 days.
- Cerebrospinal fluid drug levels were measured at the end of the dosing interval, and CSF cultures were performed for pathogen identification and treatment monitoring.
- Clinical outcomes, including fever duration, hearing deficiencies, and side effects, were recorded.
Main Results:
- Ceftriaxone achieved CSF drug levels at least 10-fold higher than the minimum inhibitory concentrations (MICs) of isolated pathogens, with an average CSF penetration of 6.6%.
- All CSF cultures were sterile within 12-46 hours after the first dose.
- Common side effects included diarrhea, exanthema, neutropenia, and transient liver enzyme elevation, none requiring therapy change. One patient developed a biliary concrement. Prolonged fever occurred in 5 patients, and 2 experienced hearing deficiencies.
Conclusions:
- Single daily intravenous ceftriaxone is a safe and effective antibiotic for treating bacterial meningitis in children.
- The drug demonstrates excellent penetration into the CSF and achieves therapeutic concentrations throughout the dosing interval.
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