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Treatment of bacterial meningitis with ceftazidime
Abstract:
Ceftazidime was prospectively evaluated in the treatment of bacterial meningitis in 19 pediatric patients. Haemophilus influenzae type b (HIB) was the etiologic agent in 17 patients, and Streptococcus pneumonia and Neisseria meningitidis were the etiologic agents in one patient each. Ceftazidime was administered intravenously in a dosage of 150 mg/kg/day divided into eight hourly doses for a mean of 15 days (range, 14 to 22 days) for H. influenzae type b meningitis. The clinical and microbiologic response was appropriate in all cases. The mean ceftazidime CSF concentration was 6.7 micrograms/ml at approximately 2 hours following iv infusions. This concentration was 16- to greater than 100-fold the minimal bactericidal concentration determined for the isolated pathogens. These preliminary observations support ceftazidime as a candidate cephalosporin for the treatment of bacterial meningitis caused by H. influenzae. Additional study is required to further define its role in meningitis caused by S. pneumoniae and N. meningitidis.
Insights
Ceftazidime effectively treated pediatric bacterial meningitis, particularly cases caused by Haemophilus influenzae type b. This cephalosporin demonstrated excellent clinical and microbiologic responses in the study.
Area of Science:
- Infectious Diseases
- Pediatrics
- Pharmacology
Background:
- Bacterial meningitis remains a significant cause of pediatric morbidity and mortality.
- Effective antibiotic therapy is crucial for improving patient outcomes.
- Cephalosporins are a key class of antibiotics used in treating bacterial meningitis.
Purpose of the Study:
- To prospectively evaluate the efficacy and safety of ceftazidime in treating bacterial meningitis in pediatric patients.
- To assess ceftazidime's cerebrospinal fluid (CSF) penetration and its relationship to minimal bactericidal concentrations (MBCs).
Main Methods:
- Prospective evaluation of 19 pediatric patients with bacterial meningitis.
- Intravenous administration of ceftazidime at 150 mg/kg/day divided into eight hourly doses for a mean of 15 days.
- Measurement of ceftazidime CSF concentrations and comparison with MBCs of isolated pathogens.
Main Results:
- Ceftazidime was administered to 19 pediatric patients with bacterial meningitis.
- Haemophilus influenzae type b (HIB) was the causative agent in 17 patients; Streptococcus pneumoniae and Neisseria meningitidis in one each.
- All patients showed appropriate clinical and microbiologic responses to ceftazidime treatment.
- Mean ceftazidime CSF concentration was 6.7 µg/ml, exceeding MBCs by 16- to >100-fold for isolated pathogens.
Conclusions:
- Ceftazidime shows promise as a cephalosporin for treating bacterial meningitis caused by H. influenzae in pediatric patients.
- Preliminary data suggest favorable clinical and microbiologic outcomes.
- Further investigation is needed to establish its role in meningitis caused by S. pneumoniae and N. meningitidis.