Pediatric Bacterial Meningitis Prognosis and Antibiotic Treatment

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  • 小児の細菌性髄膜炎における抗菌薬治療と予後
  • ショウニ ノ サイキンセイ ズイマクエン ニ オケル コウキンヤク チリョウ ト ヨゴ

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Abstract

An evaluation committee studied the relationship between initial treatment drug and prognosis in 339 of 466 subjects with bacterial meningitis treated at 108 institutions between April 2004 and January 2007, after excluding those with uncertain diagnosis or non-assessable records. Prognosis was considered unfavorable if meningitis sequelae such as quadriplegia, deafness, or epilepsy were present in 3－month follow-up; Based on this definition, 43 (12.7％) had a poor prognosis. No significant relationship was seen between unfavorable prognosis and age or causative pathogen. More had an unfavorable prognosis if treatment was initiated 4 days or later after onset. The percentage with an unfavorable prognosis was 6.4％ (4/64) in the group administered combined panipenem/betamipron (PAPM/BP) plus ceftriaxone (CTRX), 10.5％ (6/57) administered MEPM plus cefotaxime (CTX), 14.0％ (7/50) administered meropenem (MEPM) plus CTRX, and none of the 23 administered CTRX alone. The percentage with an unfavorable prognosis was 26.2％ (11/42) in those administered MEPM, significantly higher than that in those administered PAPM/BP plus CTRX,MEPM plus CTX, or CTRX alone (p＜0.05). We concluded that in initial treatment, it would be more desirable to use MEPM combined with another drug than alone.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 85 (2), 150-154, 2011

    The Japanese Association for Infectious Diseases

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