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Hearing disorders after Haemophilus influenzae meningitis. Comparison of different drug regimens
Insights
Ampicillin treatment for Haemophilus influenzae meningitis in children was linked to hearing loss and vestibular disorders. Chloramphenicol "triple therapy" may be a more effective treatment for preventing severe sequelae.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Bacteriologically verified Haemophilus influenzae meningitis affects children.
- Treatment outcomes and long-term sequelae require investigation.
Purpose of the Study:
- To evaluate audiological and neuro-otologic outcomes in children treated for Haemophilus influenzae meningitis.
- To compare the efficacy of ampicillin versus combination therapy (chloramphenicol, sulfonamides, penicillin G sodium).
Main Methods:
- Retrospective analysis of 131 children with confirmed Haemophilus influenzae meningitis.
- Long-term audiological and neuro-otologic examinations (1-15 years post-treatment).
- Comparison of outcomes based on treatment received: ampicillin vs. triple therapy.
Main Results:
- 3 children experienced total deafness, 11 moderate, and 15 minimal hearing loss.
- 6 children developed vestibular disorders.
- All deaf children and those with vestibular issues received ampicillin; triple therapy showed better outcomes.
- Severe sequelae were more prevalent in lower social groups.
Conclusions:
- Ampicillin treatment, even at low doses, was associated with significant audiological and vestibular sequelae.
- Chloramphenicol-based triple therapy appears more effective in preventing severe outcomes of Haemophilus influenzae meningitis.
- Socioeconomic factors may influence the severity of meningitis sequelae.
Abstract:
Of 131 children with bacteriologically verified Haemophilus influenzae meningitis, 75 were treated with ampicillin sodium and 45 with a combination of chloramphenicol, sulfonamides, and penicillin G sodium during the first 72 hours. Audiological and neuro-otologic examinations performed 1 to 15 years later showed that 3 patients were totally deaf, 11 had moderate and 15 minimal hearing losses, and 6 had vestibular disorders. All three deaf children and all those with recognized vestibular disorders had been treated with ampicillin. The severe sequelae, both otologic and nonotologic, tended to occur in children of the lower social groups. There were 15 ears with moderate hearing loss; the lesion was cochlear in nine and retrocochlea in four; it could not be localized in two. Ampicillin was given in relatively low dosage, but the results strongly support the value of chloramphenicol of "triple therapy" as weapons against H influenzae meningitis.