Delayed cerebrospinal fluid sterilization in infants with Hemophilus influenzae type b meningitis

J Infect Dis. 1989 Oct;160(4):711-5. doi: 10.1093/infdis/160.4.711.

Abstract

Cerebrospinal fluid (CSF) sterilization after greater than 24 h of intravenous antibiotic therapy (delayed CSF sterilization) was noted in two infants treated with ceftizoxime and ceftazidime for bacterial meningitis. A case-control study was conducted of children between 6 w and 6 y of age treated between 1975 and 1985 at one institution for bacterial meningitis to determine risk factors for delayed CSF sterilization. Hemophilus influenzae type b was isolated from all children (n = 5) with delayed CSF sterilization, compared with only 78% of all children in the study (n = 83). In children with H. influenzae type b disease, children less than 6 mo of age were at higher risk than older children for delayed CSF sterilization (odds ratio = 7.5, 95% confidence limits = 1.4, 40.0). Factors not associated with delayed CSF sterilization included time of follow-up lumbar puncture, CSF total or differential white blood cell count, and CSF protein and glucose concentrations. Despite the in vitro antimicrobial susceptibility of H. influenzae type b to ceftizoxime and ceftazidime, delayed CSF sterilization may occur in infants receiving these antibiotics for bacterial meningitis.

MeSH terms

  • Age Factors
  • Ampicillin / cerebrospinal fluid
  • Ampicillin / pharmacology
  • Ampicillin / therapeutic use*
  • Carbenicillin / cerebrospinal fluid
  • Carbenicillin / pharmacology
  • Carbenicillin / therapeutic use*
  • Case-Control Studies
  • Ceftazidime / cerebrospinal fluid
  • Ceftazidime / pharmacology
  • Ceftazidime / therapeutic use*
  • Ceftizoxime / cerebrospinal fluid
  • Ceftizoxime / pharmacology
  • Ceftizoxime / therapeutic use*
  • Child, Preschool
  • Chloramphenicol / therapeutic use
  • Drug Therapy, Combination / therapeutic use
  • Female
  • Follow-Up Studies
  • Haemophilus influenzae / drug effects
  • Haemophilus influenzae / isolation & purification
  • Humans
  • Infant
  • Male
  • Meningitis, Haemophilus / cerebrospinal fluid*
  • Meningitis, Haemophilus / drug therapy
  • Risk Factors

Substances

  • Chloramphenicol
  • Ampicillin
  • Ceftazidime
  • Ceftizoxime
  • Carbenicillin