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[Clinical evaluation of aztreonam against pediatric purulent meningitis]
R Fujii1, H Meguro, T Nishimura
1Department of Pediatrics, School of Medicine, Teikyo University.
Insights
Aztreonam (AZT) monotherapy demonstrated 100% efficacy in treating pediatric purulent meningitis. This antibiotic effectively eliminated Gram-negative pathogens like Haemophilus influenzae, Escherichia coli, and Neisseria meningitidis.
Area of Science:
- Pediatric infectious diseases
- Pharmacology and therapeutics
Background:
- Purulent meningitis poses a significant threat to pediatric patients.
- Effective antibiotic treatment is crucial for managing serious bacterial meningitis.
Purpose of the Study:
- To evaluate the efficacy and safety of aztreonam (AZT) as a monotherapy for pediatric purulent meningitis.
- To assess the microbiological eradication rates of AZT against common meningitis pathogens.
Main Methods:
- A monotherapy of aztreonam was administered to 12 pediatric patients with serious purulent meningitis.
- Dosages ranged from 134 to 400 mg/kg/day, given 3-4 times daily for 10-28 days.
- Clinical and microbiological outcomes were assessed, including pathogen identification and bacterial elimination.
Main Results:
- Aztreonam achieved a 100% clinical efficacy rate, with 5 cases rated "excellent" and 7 "good".
- Microbiological tests confirmed a 100% bacterial elimination rate, with pathogens cleared within 72 hours.
- The treatment was well-tolerated, with only mild, transient side effects observed.
Conclusions:
- Aztreonam monotherapy is highly effective and safe for treating pediatric purulent meningitis.
- AZT is particularly useful against Gram-negative pathogens such as Haemophilus influenzae, Escherichia coli, and Neisseria meningitidis.
- The study supports the use of aztreonam in managing serious pediatric meningitis cases.
Abstract:
A monotherapy of aztreonam (AZT) was applied to 9 male and 3 female pediatric patients of ages ranging from 2 months to 8 years and 11 months with serious purulent meningitis. The results are summarized as follows: 1. Daily dosages of 134 to 400 mg/kg were given 3 to 4 times a day for 10 to 28 days. 2. The isolated pathogens were Neisseria meningitidis in 2 cases, Escherichia coli in 3 cases, Haemophilus influenzae in 6 cases, but the pathogen of the last case was unknown. In this case, the patient had myelomeningocele and suffered from recurrent purulent meningitis. 3. Clinical effect was "excellent" in 5 of 12 cases, "good" in 7 cases and efficacy rate was 100%. Microbiological tests were performed on 9 cases during the course of treatment and bacterial elimination rate was 100%. All the pathogens were eliminated in 72 hours. 4. One case of diarrhea was observed, but the diarrhea started before the administration of AZT and was stopped after the AZT treatment. A slight elevation of GOT value was observed in 1 case but the value returned to the initial level promptly after the treatment was completed. It is considered that AZT is highly useful for purulent meningitis caused by Gram-negative pathogens such as H. influenzae, E. coli and N. meningitidis.