Cefotaxime in pneumococcal meningitis

Lecour, Henrique; Seara, Anselmo Padín; Miranda, Alice; Cordeiro, J.

doi:10.1007/bf01644223

Cited by 10 publications

(2 citation statements)

References 15 publications

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“…We found additional studies specifically reporting on S pneumoniae (113 studies; 24 553 episodes) (eTable 8 in Supplement 1), N meningitidis (75 studies; 100 278 episodes) (eTable 9 in Supplement 1), H influenzae (49 studies; 28 796 episodes) (eTable 10 in Supplement 1), L monocytogenes (15 studies; 985 episodes) (eTable 11 in Supplement 1),…”

Section: Resultsmentioning

confidence: 99%

“…We found additional studies specifically reporting on S pneumoniae (113 studies; 24 553 episodes) (eTable 8 in Supplement 1 ), 394 , 395 , 396 , 397 , 398 , 399 , 400 , 401 , 402 , 403 , 404 , 405 , 406 , 407 , 408 , 409 , 410 , 411 , 412 , 413 , 414 , 415 , 416 , 417 , 418 , 419 , 420 , 421 , 422 , 423 , 424 , 425 , 426 , 427 , 428 , 429 , 430 , 431 , 432 , 433 , 434 , 435 , 436 , 437 , 438 , 439 , 440 , 441 , 442 , 443 , 444 , 445 , 446 , 447 , 448 , 449 , 450 ...…”

Section: Resultsmentioning

confidence: 99%

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Global Case Fatality of Bacterial Meningitis During an 80-Year Period

van Ettekoven,

Liechti,

Brouwer

et al. 2024

JAMA Netw Open

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ImportanceThe impact of vaccination, antibiotics, and anti-inflammatory treatment on pathogen distribution and outcome of bacterial meningitis over the past century is uncertain.ObjectiveTo describe worldwide pathogen distribution and case fatality ratios of community-acquired bacterial meningitis.Data SourcesGoogle Scholar and MEDLINE were searched in January 2022 using the search terms bacterial meningitis and mortality.Study SelectionIncluded studies reported at least 10 patients with bacterial meningitis and survival status. Studies that selected participants by a specific risk factor, had a mean observation period before 1940, or had more than 10% of patients with health care–associated meningitis, tuberculous meningitis, or missing outcome were excluded.Data Extraction and SynthesisData were extracted by 1 author and verified by a second author. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Random-effects models stratified by age (ie, neonates, children, adults), Human Development Index (ie, low-income or high-income countries), and decade and meta-regression using the study period’s year as an estimator variable were used.Main Outcome and MeasureCase fatality ratios of bacterial meningitis.ResultsThis review included 371 studies performed in 108 countries from January 1, 1935, to December 31, 2019, describing 157 656 episodes. Of the 33 295 episodes for which the patients’ sex was reported, 13 452 (40%) occurred in females. Causative pathogens were reported in 104 598 episodes with Neisseria meningitidis in 26 344 (25%) episodes, Streptococcus pneumoniae in 26 035 (25%) episodes, Haemophilus influenzae in 22 722 (22%), other bacteria in 19 161 (18%) episodes, and unidentified pathogen in 10 336 (10%) episodes. The overall case fatality ratio was 18% (95% CI, 16%-19%), decreasing from 32% (95% CI, 24%-40%) before 1961 to 15% (95% CI, 12%-19%) after 2010. It was highest in meningitis caused by Listeria monocytogenes at 27% (95% CI, 24%-31%) and pneumococci at 24% (95% CI, 22%-26%), compared with meningitis caused by meningococci at 9% (95% CI, 8%-10%) or H influenzae at 11% (95% CI, 10%-13%). Meta-regression showed decreasing case fatality ratios overall and stratified by S pneumoniae, Escherichia coli, or Streptococcus agalactiae (P &lt; .001).Conclusions and RelevanceIn this meta-analysis with meta-regression, declining case fatality ratios of community-acquired bacterial meningitis throughout the last century were observed, but a high burden of disease remained.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Global Case Fatality of Bacterial Meningitis During an 80-Year Period

van Ettekoven,

Liechti,

Brouwer

et al. 2024

JAMA Netw Open

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Entzündliche Erkrankungen des ZNS

Vieregge¹

1989

Spezielle Neurologische Therapie

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Cefotaxime monotherapy of bacterial meningitis caused by gram-positive pathogens

Helwig

1985

Infection

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Primary meningitis in children is caused by two gram-negative bacterial species, Neisseria meningitidis and Haemophilus influenzae, and one gram-positive bacterial species Streptococcus pneumoniae. Despite optimal penicillin susceptibility, with few exceptions, therapeutic results in pneumococcal meningitis are by far worse than with the other two pathogens. Therefore, and because of the detection of penicillin-resistant rods, the study of alternatives in therapy is justified and was started with cefotaxime. Including six of our own patients, there are reports on 87 patients in the literature suffering from S. pneumoniae meningitis who were treated with cefotaxime monotherapy. Results of these studies will be analyzed. As none of these patients belonged to a prospective controlled study group, final evaluation in comparison with penicillin therapy remains open. There are also several reports on successful treatment of group B streptococcus meningitis with cefotaxime, although there is no need to abandon penicillin therapy. Staphylococcus aureus and Staphylococcus epidermidis meningitis, usually secondary in shunted hydrocephalus, brain tumors, brain injury or other causes, should not be treated with cefotaxime because of its limited activity on these bacteria. Listeria monocytogenes and Streptococcus faecalis are primarily cefotaxime-resistant, and neonatal meningitis of unknown origin, therefore, should not be treated with cefotaxime alone as long as these pathogens cannot be excluded.

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Cefotaxime in pneumococcal meningitis

Cited by 10 publications

References 15 publications

Global Case Fatality of Bacterial Meningitis During an 80-Year Period

Global Case Fatality of Bacterial Meningitis During an 80-Year Period

Entzündliche Erkrankungen des ZNS

Cefotaxime monotherapy of bacterial meningitis caused by gram-positive pathogens

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