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Cefotaxime therapy of neonatal gram-negative bacillary meningitis
Abstract:
Seven neonates were treated with cefotaxime during eight episodes of Gram-negative bacillary meningitis and sepsis. The causative organisms were Escherichia coli in six cases and Klebsiella pneumoniae and Enterobacter sakazakii in one each. After identification of the pathogen cefotaxime was used alone in six instances. Two patients with brain abscesses received adjunctive therapy with another antibiotic. The sterility of cerebrospinal fluid was documented after a mean of 3.3 days of therapy. Mean cerebrospinal fluid bactericidal titer was 1:64. All patients recovered with good neurologic outcome. Cefotaxime in a dosage of 150 mg/kg/day divided every 6 hours intravenously seems safe and effective therapy for neonatal Gram-negative bacillary meningitis.
Insights
Cefotaxime effectively treated Gram-negative meningitis and sepsis in neonates. This antibiotic demonstrated safety and efficacy, leading to good neurologic outcomes in all treated infants.
Area of Science:
- Neonatal infectious diseases
- Pediatric neurology
- Pharmacology
Background:
- Gram-negative bacillary meningitis and sepsis pose significant risks to neonates.
- Effective antibiotic therapy is crucial for improving outcomes in affected infants.
Purpose of the Study:
- To evaluate the safety and efficacy of cefotaxime in treating neonatal Gram-negative bacillary meningitis and sepsis.
- To assess the clinical and microbiological response to cefotaxime therapy.
Main Methods:
- Retrospective analysis of seven neonates treated for Gram-negative bacillary meningitis/sepsis.
- Cefotaxime administered at 150 mg/kg/day intravenously, divided every 6 hours.
- Cerebrospinal fluid sterility and bactericidal titers were monitored.
Main Results:
- Causative organisms included Escherichia coli, Klebsiella pneumoniae, and Enterobacter sakazakii.
- Cerebrospinal fluid sterilization achieved within a mean of 3.3 days.
- Mean cerebrospinal fluid bactericidal titer was 1:64.
- All patients recovered with favorable neurologic outcomes.
Conclusions:
- Cefotaxime is a safe and effective treatment for neonatal Gram-negative bacillary meningitis and sepsis.
- Intravenous cefotaxime at 150 mg/kg/day is recommended for this patient population.
- Early administration of cefotaxime contributes to positive neurologic outcomes.