Cefuroxime versus ampicillin plus chloramphenicol in childhood bacterial meningitis: A multicenter randomized controlled trial
| Autor: | Jon S. Abramson, Frederick Cox, Warren A. Marks, Melvin I. Marks, Mark D. Tolpin, Elia M. Ayoub, William A. Geffen, Duane D. Harrison, Sharon G. Paryani, Harris R. Stutman, Christopher J. Harrison, Stephen A. Chartrand |
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| Rok vydání: | 1986 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.drug_class Antibiotics Meningitis Meningococcal medicine.disease_cause Haemophilus influenzae Random Allocation Ampicillin Internal medicine Streptococcus pneumoniae medicine Humans Meningitis Child Meningitis Haemophilus Cefuroxime Clinical Trials as Topic Meningitis Pneumococcal business.industry Chloramphenicol Infant Bacterial Infections medicine.disease Cephalosporins Surgery Child Preschool Bacteremia Pediatrics Perinatology and Child Health Drug Therapy Combination Female business medicine.drug |
| Zdroj: | The Journal of Pediatrics. 109:123-130 |
| ISSN: | 0022-3476 |
| DOI: | 10.1016/s0022-3476(86)80591-1 |
| Popis: | In a multicenter randomized trial, 107 children with bacterial meningitis were initially given either cefuroxime or ampicillin plus chloramphenicol. Patients were alternately assigned to 7- or 10-day courses of the designated antimicrobial regimen. CSF isolates included Haemophilus influenzae type b (89, of which 25% were β -lactamase positive), Streptococcus pneumoniae (11), and Nelsseria meningitidis (7). Although mean CSF bactericidal titers against Haemophilus isolates were 1:6 in each treatment group, H. influenzae was cultured from CSF in four of 39 patients receiving cefuroxime, 24 to 48 hours after initiation of therapy, compared with none of 40 patients given ampicillin plus chloramphenicol (P=0.11). Clinical cure rates were similar (95%); one death occurred in each group. One child given cefuroxime had persistent meningitis after 5 days of therapy, and mastoiditis with secondary bacteremia developed in one on day 10. Three patients had relapse or reinfection. One patient who received cefuroxime for 10 days had a relapse of epigiottitis 17 days later, and of the patients given ampicillin plus chloramphenicol, one had a relapse of meningitis 1 week after 7 days of therapy, and bacteremia developed in one 42 days after completion of 10 days of therapy. No increase in either in-hospital complications or relapses occurred with a 7-day treatment course. Proof of the equivalence of the antibiotic regimens and the efficacy of 7-day courses of treatment, as well as the consequences of delayed CSF sterilization, will require additional investigation. |
| Databáze: | OpenAIRE |
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