Document Detail


Seven days vs. 10 days ceftriaxone therapy in bacterial meningitis.
MedLine Citation:
PMID:  12405169     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ceftriaxone is recommended in children with acute bacterial meningitis (ABM) for 10 days. However, the drug is expensive, and shorter duration of therapy, if equally effective, would cut costs of therapy and hospitalization. The aim of this study was to compare the outcome of 7 days vs. 10 days' ceftriaxone therapy in children with ABM. Seventy-three children aged 3 months to 12 years with ABM, consecutively admitted to hospital were enrolled. Ceftriaxone was given for 7 days to all. Randomization to group I (7 days) and group II (10 days) therapy was done on the seventh day. At the end of 7 days' therapy in group I and 10 days in group II, children were evaluated using a clinical scoring system. Children with a score of more than 10 were labelled as 'treatment failures' and were continued on ceftriaxone. If a score was less than 10, the antibiotic was stopped. Complications were appropriately evaluated and managed. All children were followed-up 1 month after discharge: neurodevelopmental assessment, Denver Development Screening Tests, IQ and hearing assessment were done. After excluding four patients, there were 35 children in group I and 34 in group II. The two groups were comparable with respect to age, sex, nutritional status, presenting clinical features, and CSF parameters. Organism identification was possible in 38 per cent of children: (Streptococcus pneumoniae, 21 per cent; Haemophilus influenzae, 13 per cent; meningococcus, 4 per cent). Treatment failure rate was comparable in both groups (9 in group I and 8 in group II) as was the sequelae at discharge and at 1 month (9 in group I, 15 in group II,p > 0.1). Status epilepticus and focal deficits at presentation were significantly associated with treatment failures and sequelae in both the groups (p < 0.05). Length of hospital stay was shorter in group I (10.8 +/- 6.0 days) as compared with group II (14.4 +/- 7.2 days,p < 0.05) and frequency of nosocomial infection was significantly more in group II (p < 0.05). It was concluded that clinical outcome of patients treated with 7 days' ceftriaxone therapy is similar to that of 10 days' therapy, and is associated with lesser nosocomial infection and earlier hospital discharge. Seven days ceftriaxone therapy may be recommended for uncomplicated ABM in children in developing countries.
Authors:
Pratibha Singhi; Monika Kaushal; Sunit Singhi; Pallabh Ray
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of tropical pediatrics     Volume:  48     ISSN:  0142-6338     ISO Abbreviation:  J. Trop. Pediatr.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-30     Completed Date:  2002-12-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8010948     Medline TA:  J Trop Pediatr     Country:  England    
Other Details:
Languages:  eng     Pagination:  273-9     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drsinghi@glide.net.in
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MeSH Terms
Descriptor/Qualifier:
Ceftriaxone / administration & dosage*
Cephalosporins / administration & dosage*
Chi-Square Distribution
Child
Child, Preschool
Drug Administration Schedule
Female
Humans
Infant
Male
Meningitis, Bacterial / drug therapy*,  microbiology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cephalosporins; 73384-59-5/Ceftriaxone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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