Related Experiment Videos
Treatment of childhood bacterial meningitis
H Lecour1, A Seara, J Cordeiro
1Department of Infectious Diseases, School of Medicine, Hospital S. Joao, Porto, Portugal.
Abstract:
One hundred and eighty-seven children with identified bacterial meningitis were treated with intravenous cefotaxime: 15 patients were neonates, 79 infants, and 93 were aged from 1 to 14 years. Causative organisms were: Neisseria meningitidis in 80 cases, Streptococcus pneumoniae in 41, Haemophilus influenzae in 40, enteric gram-negative bacilli in 20 and Staphylococcus spp. in six. Enteric gram-negative bacilli included: Salmonella spp. in 14 cases, Klebsiella pneumoniae in two, and Escherichia coli, Enterobacter sakazakii and Acinobacter calcoaceticus in one each; in one case the organism was not specified. Daily dose of cefotaxime was 150 to 300 mg/kg. Concomitant treatment with an aminoglycoside was used in seven cases. One hundred and seventy-two patients (92.0%) were cured. Fever persisted for a mean of five days and meningeal signs for a mean of four days. Fifteen (8.0%) patients died: most [13] of them were admitted in coma, and two in shock. Death occurred in the first 48 h in ten cases. Sterilization of CSF was achieved in the first 72 h of treatment in 155 (90.1%) of the cured patients. Cefotaxime was well tolerated. CSF penetration of cefotaxime was evaluated in seven patients: concentrations ranged from 0.499 mg/l to 2.829 mg/l. Based on this clinical study, cefotaxime is an effective and safe drug for the treatment of childhood bacterial meningitis.
Insights
Cefotaxime effectively treated bacterial meningitis in 187 children, with a 92% cure rate. This antibiotic demonstrated good tolerability and safety for pediatric bacterial meningitis treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Bacterial meningitis remains a significant cause of childhood morbidity and mortality.
- Effective antibiotic therapy is crucial for improving outcomes in pediatric bacterial meningitis.
- Cefotaxime is a third-generation cephalosporin with broad-spectrum activity against common meningitis pathogens.
Purpose of the Study:
- To evaluate the efficacy and safety of intravenous cefotaxime in treating bacterial meningitis in children.
- To assess the clinical outcomes, including cure rates and mortality, associated with cefotaxime treatment.
- To analyze the microbiological spectrum of bacterial meningitis and the response to cefotaxime therapy.
Main Methods:
- A clinical study involving 187 children diagnosed with bacterial meningitis.
- Treatment administered via intravenous cefotaxime at doses of 150 to 300 mg/kg daily.
- Causative organisms identified, and clinical outcomes (cure, death, fever duration, meningeal signs duration) were recorded.
Main Results:
- A high cure rate of 92.0% (172 out of 187 patients) was achieved.
- Common causative organisms included Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae.
- Cerebrospinal fluid (CSF) sterilization occurred within 72 hours in 90.1% of cured patients; cefotaxime was well tolerated.
Conclusions:
- Intravenous cefotaxime is an effective and safe therapeutic option for childhood bacterial meningitis.
- The drug demonstrated favorable clinical outcomes and good tolerability in the pediatric population.
- Early CSF sterilization and high cure rates support the use of cefotaxime in managing this serious infection.