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Association of treatment for bacterial meningitis with the development of sequelae

Kalliopi Theodoridou1, Vasiliki A Vasilopoulou, Anna Katsiaflaka

  • 1Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str, 41222, Larissa, Greece.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|March 30, 2013
PubMed
Abstract

Insights

Treatment for childhood bacterial meningitis significantly impacts neurological outcomes. Penicillin showed protective effects, while other antibiotics like chloramphenicol and cephalosporins increased risks for conditions such as ventriculitis and hydrocephalus.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Bacterial meningitis is a severe infectious disease in children.
  • It can lead to disabling long-term neurological sequelae.
  • Understanding treatment's role in sequelae development is crucial.

Purpose of the Study:

  • To assess how different treatments influence the development of neurological sequelae in childhood bacterial meningitis.
  • To identify specific antimicrobial agents associated with positive or negative outcomes.

Main Methods:

  • Analysis of 2,477 pediatric patients (1 month-14 years) with acute bacterial meningitis over 32 years.
  • Data collected prospectively from a tertiary university hospital's Meningitis Registry.
  • Univariate and multivariate analyses evaluated treatment effects on seizure disorder, hearing loss, ventriculitis, and hydrocephalus.

Main Results:

  • Penicillin demonstrated a protective effect against ventriculitis (OR 0.17).
  • Chloramphenicol increased risks for ventriculitis (OR 17.77) and seizure disorder (OR 4.72).
  • Cephalosporins were linked to higher risks of hydrocephalus (OR 5.24) and ventriculitis (OR 5.72).
  • Trimethoprim/sulfamethoxazole increased seizure disorder (OR 3.26) and ventriculitis (OR 8.60) risks.
  • Hydrocortisone was associated with increased hydrocephalus (OR 5.44); dexamethasone showed no significant protective effect.

Conclusions:

  • Antimicrobial treatment choice for childhood bacterial meningitis can positively or negatively affect neurological sequelae.
  • Specific antibiotics have differential impacts on the risk of developing conditions like ventriculitis, hydrocephalus, and seizure disorders.
Keywords:
Bacterial meningitisChildPrognosisSequelaeTreatment

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