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Hearing impairment following therapy of Haemophilus influenzae meningitis
Abstract:
From 97 children with bacteriologically confirmed Haemophilus influenzae meningitis, 39 were treated with chloramphenicol (before 1970) and 58 with ampicillin (since 1970). In 1977 all patients were followed up with history, clinical examination, and audiometry. Sensorineural hearing defect was found in 5 chloramphenicol patients and in 10 ampicillin patients. Of the 82 patients for whom treatment was begun within 48 h of onset of symptoms, only two showed hearing deficit, while 13 of the 15 patients in whom treatment was begun later suffered from hearing impairment. It appears that it is not the antibiotic, but the delay between onset of symptoms and start of therapy, that is decisive for the occurrence of inner ear impairment.
Insights
Early treatment for Haemophilus influenzae meningitis is crucial for preventing hearing loss. Delays in starting antibiotic therapy, not the specific drug used, significantly increase the risk of sensorineural hearing defects in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Audiology
Background:
- Haemophilus influenzae meningitis is a serious childhood infection.
- Antibiotic treatment has evolved, with chloramphenicol used historically and ampicillin more recently.
- Hearing impairment is a known complication of bacterial meningitis.
Purpose of the Study:
- To investigate the long-term hearing outcomes in children treated for Haemophilus influenzae meningitis.
- To compare the effects of chloramphenicol versus ampicillin on hearing.
- To identify factors influencing the development of sensorineural hearing defects.
Main Methods:
- Retrospective follow-up of 97 children with confirmed Haemophilus influenzae meningitis.
- Data collection included medical history, clinical examination, and audiometry in 1977.
- Patients were categorized by antibiotic treatment (chloramphenicol or ampicillin) and treatment delay.
Main Results:
- Sensorineural hearing defects were observed in both treatment groups.
- A significantly higher incidence of hearing impairment was noted in patients whose treatment began more than 48 hours after symptom onset.
- Only two out of 82 patients treated within 48 hours developed hearing deficits.
Conclusions:
- The timing of antibiotic initiation is a critical determinant of hearing outcomes in Haemophilus influenzae meningitis.
- Delayed treatment, rather than the choice of antibiotic (chloramphenicol vs. ampicillin), is strongly associated with inner ear impairment.
- Prompt medical intervention is essential to minimize the risk of hearing loss in pediatric meningitis cases.