Antibiotic therapy of atypical bacterial meningitis in children
Liao JX, Chen L, Hu Y,
Li CG, Li CR
Shenzhen Children’s
Hospital, Shenzhen, China 518026
Objective: To explore
antibiotic therapy of child atypical bacterial meningitis.
Methods: Retrospectively
analyses the data of 21 patients with bacterial meningitis between 1997 and
2000.
Results: Of 21
patients definite pathogen were detected in only 2, 4 developed
complications (group A) of subdural effusion or/and hydrocephalus. Others
were groups B, which diagnosed as atypical bacterial meningitis, and had no
complications. 6 had typical cerebral spinal fluid (CSF) features of
purulent meningitis. Penicillin and Rocephin® were the major
antibiotics used. The duration before admission to hospital of the two
groups was 4.25±1.92(n=4) vs 3.29±1.89(n=17)
days, the fever course after
admission was 8.50±2.69(n=4) vs
5.29±4.03(n=13)
days, duration for the cerebral spinal fluid recovering to normal was 23.50±5.17(n=4) vs 11.67±8.37(n=7, p＜0.05) days, duration of
hospitalization was 31.25±7.69(n=4) vs
14.93±10.53(n=15 p＜0.02) days respectively.
The duration for CSF normalized and hospitalization was significantly
different between two groups.
Conclusions: Atypical
bacterial meningitis gradually increased in children, antibiotics should
aim at both Gram positive and Gram negative bacteria when we did not know
the exact pathogens, and when the bacterial meningitis was not typical.
Other alternative antibiotics should be selected. The duration of treatment
should be individualized according to the clinical and CSF states.