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[Treatment of type-b H. influenzae meningitis resistant to ampicillin and chloramphenicol]
Abstract:
Three cases of H. influenzae type b meningitis with resistance to ampicillin and cloramphenicol are described. All infants were treated with new cephalosporin derivates. CSF sterilization was achieved in all patients. Clinical evolution was good in the two old infants treated with cefotaxime, nevertheless younger infant treated with cephoxitin developed serious neurologic and psychologic sequelae. H. influenzae b was erradicated of a carrier mother after four days of rifampicin therapy. Finding of multiple-resistance H. influenzae type b meningitis and therapeutics problems are emphasized by authors.
Insights
This study reports on three cases of ampicillin- and chloramphenicol-resistant Haemophilus influenzae type b meningitis in infants. While new cephalosporins showed promise, treatment outcomes varied, highlighting therapeutic challenges.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Meningitis caused by Haemophilus influenzae type b (Hib) poses a significant threat to infants.
- Emergence of antibiotic resistance in Hib necessitates evaluation of alternative treatment strategies.
Observation:
- Three infants presented with Hib meningitis exhibiting resistance to ampicillin and chloramphenicol.
- Two older infants treated with cefotaxime showed good clinical recovery.
- A younger infant treated with cephoxitin experienced severe neurologic and psychologic sequelae.
Findings:
- Cerebrospinal fluid (CSF) sterilization was achieved in all treated infants.
- Treatment with cefotaxime was associated with favorable outcomes in older infants.
- Cephoxitin treatment in a younger infant resulted in adverse neurologic and psychologic sequelae.
- Rifampicin therapy successfully eradicated Hib from a carrier mother.
Implications:
- Highlights the challenges in treating multidrug-resistant Hib meningitis.
- Suggests differential efficacy of newer cephalosporins based on patient age and specific drug.
- Emphasizes the need for ongoing surveillance of antibiotic resistance patterns in Hib.