Prospective Comparison of Ceftriaxone and Cefotaxime for the Short-Term Treatment of Bacterial Meningitis in Children

Abstract

The effectiveness and safety of ceftriaxone and cefotaxime in the short-term treatment of primary bacterial meningitis were compared using a prospective, randomized, multicenter study design. Children between the ages of 6 weeks and 16 years received either ceftriaxone as a single dose (100 mg/kg on the first day followed by 75 mg/kg/day) or cefotaxime as four divided doses (200 mg/kg/day) for 4–7 days. A total of 82 patients (44 ceftriaxone, 38 cefotaxime) with documented bacteria in the CSF were studied. In patients receiving ceftriaxone, full recovery occurred in 79.5% while a further 13.7% recovered with neurologic sequelae. Full recovery was observed in 71.1% of children treated with cefotaxime with sequelae in a further 23.6% (no statistically significant differences between drugs). The time to clinical improvement and resolution of fever (3–4 days) was also similar for both drugs. All but 1 of the 82 patients studied had negative CSF cultures within 24 h of the beginning of therapy consistent with the excellent penetration into the CSF (trough concentrations of 2.7 mg/l for both drugs at the end of therapy). No differences were observed in the incidence of clinically significant adverse events. Ceftriaxone and cefotaxime are both effective in the treatment of bacterial meningitis. Ceftriaxone offers an advantage in ease of administration since it is administered as a single daily dose.

Statically study of third generation Cephalosporin (Cefotaxime) quantities uses in some Iraqi provinces

“…It indication used to treat gonorrhoea, meningitis, and severe infections including infections of the kidney (Pyelonephritis) and urinary system. Also used before an operation to prevent infection after surgery (18).…”

Neisseria meningitidis: a neglected cause of infectious haemorrhagic fever in the amazon rainforest

“…In that forest land, short-course treatment protocols and antibiotics with simple treatment schedules with the possibility of intramuscular injection for prior antibiotic therapy are necessary [3]. One daily dose of ceftriaxone (100 mg/Kg to a maximum of 4 g) administered intramuscularly seems to be a suitable option for the treatment of meningococcal disease and bacterial meningitis taking into account the circumstances found in Amazon inlands, its efficacy, and ease of use [27,28]. The occurrence of meningococcal disease in rural communities in the Amazon Region represents a public health challenge to decisions that are made regarding case ascertainment, outcome, and control of linked cases.…”

Revival of Landing's Concept of Infantile Obstructive Cholangiopathy – A Plea to Hand Over the 2 Week Old Jaundiced Full Term Neonate to the Surgeon!

“…The pathogenesis of sludge is similar to that of gallstones, which are formed from precipitating sludge 30 . There are many predisposing factors to the development of inspissated bile, sludge, or cholelithiasis in neonates 31,32 Ceftriaxone pseudolithiasis, composed of precipitated ceftriaxone, is reported to occur in 29.5% to 45.7% of children treated with ceftriaxone 33 . The pseudolithiasis occurs after 4 to 22 days (mean, 9 days) of ceftriaxone therapy and resolves after 2 to 63 days (mean, 15 days) from the end of treatment 34 .Cefotaxime, was previously reported to be associated with pseudolithiasis in 2 of 34 infants (6%) who had cholelithiasis 31 .…”