Treatment of 160 cases of acute bacterial meningitis with cefotaxime

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Abstract
One hundred and sixty cases of acute bacterial meningitis were treated with cefotaxime. Patients were between 9 days and 79 years old: 7 new borns, 37 infants, 43 children, 19 adolescents and 54 adults. Fifty-eight patients (36%) were in coma when admitted. Aetiology was determined in 110 patients (68.8%): Neisseria meningitidis in 42, Streptococcus pneumoniae in 36, Haemophilus influenzae in 16, Salmonella spp. in 7, Staphylococcus aureus in 2, Enterobacter spp. in 2 and Haemophilus parainfluenzae, pseudomonas aeruginosa, Escherichia coli, Citrobacter freundii and Klebsiella pneumoniae in one patient each. All isolates were sensitive to cefotaxime, with MIC's for 26 strains ranging from 0.01 to 0.50 mg/1. One hundred and fifty-six of the 160 patients were treated with cefotaxime alone and the four others with cefotaxime in association with an aminoglycoside in three and rifampicin in one. Cefotaxime was administered by intravenous infusion, in a daily dose 100 to 300 mg/kg. Duration of treatment ranged from 8 days to 6 weeks, with a mean of 15 days. One hundred and forty-nine patients (93.1%) were cured, two after a relapse. Three patients had sequelae. Most (88.5%) had sterile CSF within 72 h after starting treatment. Eleven patients (6.9%) died, eight within the first 48 h. The only side-effects observed were mild transient eosinophilia in some patients and rash and leukopenia in 2 each. The study demonstrates that cefotaxime is effective in the treatment of acute bacterial meningitis.

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