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Intravenous cefotaxime in children with bacterial meningitis
Insights
Cefotaxime effectively treated bacterial meningitis in children resistant to other antibiotics. Most patients recovered, demonstrating cefotaxime
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Pharmacology
Background:
- Bacterial meningitis poses a significant threat to children.
- Antibiotic resistance complicates treatment of pediatric meningitis.
- Cefotaxime is a third-generation cephalosporin with broad-spectrum activity.
Purpose of the Study:
- To evaluate the efficacy and tolerability of intravenous cefotaxime in children with bacterial meningitis.
- To assess cefotaxime's effectiveness against antibiotic-resistant or previously unsuccessfully treated meningitis cases.
Main Methods:
- Retrospective analysis of 13 pediatric cases of bacterial meningitis.
- Treatment administered via intravenous cefotaxime.
- Cerebrospinal fluid (CSF) cefotaxime levels measured in seven patients.
Main Results:
- Nine out of 13 children were cured.
- One patient experienced a recurrence successfully treated with a second course of cefotaxime.
- One child died with sterile CSF, another from an underlying condition, and one had sequelae (hydrocephalus).
- Cerebrospinal fluid cefotaxime concentrations were high, exceeding typical minimum inhibitory concentrations.
Conclusions:
- Intravenous cefotaxime demonstrated significant efficacy in treating pediatric bacterial meningitis, including cases with resistant organisms.
- Cefotaxime was well-tolerated in this pediatric population.
- The drug achieved therapeutic concentrations in the cerebrospinal fluid, supporting its use in meningitis treatment.
Abstract:
Thirteen children with meningitis due to Haemophilus influenzae, beta-haemolytic streptococcus group B, Streptococcus pneumoniae, Staphylococcus epidermidis, Neisseria meningitidis, Escherichia coli, or Pseudomonas aeruginosa and who had been unsuccessfully treated with other antibiotics or had causative organisms which were resistant to available antibiotics were treated with intravenous cefotaxime. Nine children were cured; in one case infection (with a different organism) recurred but a further course of cefotaxime was successful; one child died, with sterile CSF; one child died from his underlying disease (astrocytoma); and one child was cured with sequelae (hydrocephalus). A further child with meningitis caused by E. coli had been treated unsuccessfully by intravenous and intraventricular chloramphenicol and gentamicin; intravenous and intraventricular cefotaxime was successful. The agent was well tolerated. CSF levels were measured in seven children and ranged from 300 to 27 200 microgram/l; published and unpublished in-vitro studies suggest that minimum inhibitory concentrations for cefotaxime against the organisms commonly causing bacterial meningitis are usually well below 250 microgram/l.