Update on the use of cefotaxime for pediatric meningitis in Portugal

Lecour, Henrique; Miranda, Alice; Nogueira, José Manuel Freire; Abreu, Cândida

doi:10.1016/0732-8893(95)00085-o

Cited by 4 publications

(5 citation statements)

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“…We retrieved 371 studies with 427 study periods performed from January 1, 1935, to December 31, 2019, in 108 countries, describing 157 656 episodes of community-acquired bacterial meningitis …”

Section: Resultsmentioning

confidence: 99%

“…N meningitidis was among the most frequent pathogens in children and adults (250 studies; 274 study periods; 123 830 episodes) (eTable 16 and eFigure 27 in Supplement 1). This sample was dominated by a Nigerian study describing an outbreak in 2009 with more than 50 000 patients . The overall CFR was 8.8% (95% CI, 8.0% to 9.7%) (eFigure 28 in Supplement 1); CFR was 11% (95% CI, 8% to 16%) before 1961 and 7.2% (95% CI, 5.8.% to 8.7%) i...…”

Section: Resultsmentioning

confidence: 99%

“…H influenzae was among the most frequent pathogens in children (226 of 630 studies [36%]; 249 of 733 study periods [34%]; 49 539 of 314 454 episodes [16%]) (eTable 18 and eFigure 32 in Supplement 1). The overall CFR was 11% (95% CI, 10% to 13%) (eFigure 33 in Supplement 1); CFR was 13% (95% CI, 10% to 18%) before 1961 and 10% (95% CI, 7% to 16%) after 2010. CFR was higher in low-income countries (23%; 95% CI, 19% to 29%) compared with high-income countries (7%; 95% CI, 5% to 9%) (eTable 19 in Supplement 1) and did not decrease substantially during the period (0.7% per year; 95% CI, −0.3% to 1.7% per year; P = .17) (eFigures 34 to 36 in Supplement 1).…”

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%

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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“…While 17 children were treated with cefotaxime, either alone or in combination with ampicillin, 2 children received ceftriaxone (table 1). It has been shown that CSF sterilization occurs within 48 h of initiation of such treatment [1,3,7], although this could not be proved because parents often refused to allow repeat lumbar puncture. Nine (45%) of our patients received concomitant dexamethasone although reports on its efficacy in reducing sequelae have been conflicting [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…The third-generation cephalosporins, namely cefotaxime and ceftriaxone, have been proven to be effective in the management of childhood bacterial meningitis beyond the neonatal period [1,5,7]. While these agents present excellent in vitro antimicrobial activity against Hib with minimum inhibitory concentration (MIC) ranging from 0.002 to 632 Ìg/ml, ß-lactamase-positive, Dhar/Badawi/Al Haque/Mubasher/ Qabazard/Sadek/Zaki ampicillin-resistant strains have increased to 630% in some centres [1,4,8].…”

Section: Discussionmentioning

confidence: 99%

Outcome of Treatment of <i>Haemophilus influenzae</i> Meningitis in Children Complicated by Febrile Episodes

Dhar¹,

Badawi

Haque

et al. 2000

Med Princ Pract

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Aim: In this retrospective study, 20 cases of Haemophilus influenzae type b (Hib) meningitis were analysed to assess the outcome of treatment. Methods: Bacteriologically proven cases of meningitis due to Hib were included in this study. The clinical and relevant laboratory data were retrieved from the hospital files. Results: Thirteen patients were treated with a combination of cefotaxime and ampicillin, 4 with cefotaxime, 2 with ceftriaxone and 1 with a combination of ampicillin and chloramphenicol. Only 9 children received concomitant dexamethasone. Nine (45%) cases experienced permanent defervescence within 4 days of admission and were discharged from the hospital after an average stay of 10.5 days. The overall rates of secondary (25%), persistent (5%) and prolonged fever (25%) were observed with an average number of days in hospital of 20.4, 20.0 and 22.8, respectively. Conclusion: Although there was no mortality, there is still a need for appropriate short-duration therapy which will help in bringing about a decline in febrile episodes, thereby reducing cost of management and hospital stay.

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Jones

1995

Diagnostic Microbiology and Infectious Disease

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Update on the use of cefotaxime for pediatric meningitis in Portugal

Cited by 4 publications

References 11 publications

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

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

Outcome of Treatment of <i>Haemophilus influenzae</i> Meningitis in Children Complicated by Febrile Episodes

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