How do third generation cephalosporins compare with conventional antibiotics at improving outcomes in people with acute bacterial meningitis?

2014 ◽  
Author(s):  
Mrinal Yadava
Keyword(s):  
Bacterial Meningitis ◽  
Acute Bacterial Meningitis ◽  
Third Generation ◽  
Conventional Antibiotics ◽  
Third Generation Cephalosporins

scholarly journals Meropenem versus Cefotaxime and Ampicillin as Empirical Antibiotic Treatment in Adult Bacterial Meningitis: a Quality Registry Study, 2008 to 2016

2019 ◽  
Vol 63 (11) ◽  
Author(s):  
Magnus Brink ◽  
Martin Glimåker ◽  
Jan Sjölin ◽  
Pontus Naucler
Keyword(s):  
Propensity Score ◽  
Bacterial Meningitis ◽  
Propensity Score Matching ◽  
Primary Outcome ◽  
Empirical Treatment ◽  
Acute Bacterial Meningitis ◽  
Quality Registry ◽  
Treatment Regimens ◽  
Quality Register ◽  
Third Generation Cephalosporins

ABSTRACT Cefotaxime, alone or with ampicillin, is frequently used in empirical treatment of acute bacterial meningitis (ABM). Meropenem is a less extensively investigated alternative. The aim of the study was to investigate the effects of empirical treatment with meropenem compared to cefotaxime plus ampicillin on outcome in ABM. The study was based on data from the Swedish quality register for ABM collected between January 2008 and December 2016. Propensity score matching was performed to adjust for baseline differences between the groups. Mortality within 30 days was the primary outcome. The treatment regimens of interest were administered to 623 patients; 328 were given cefotaxime plus ampicillin whereas 295 received meropenem. Using propensity score matching, the 30-day mortality rates were 3.2% in the cefotaxime plus ampicillin group and 3.6% in the meropenem group. For matched cases, the odds ratio (OR) for 30-day mortality for meropenem versus cefotaxime plus ampicillin was 1.15 (confidence interval [CI], 0.41 to 3.22; P = 0.79). The OR for 90-day mortality was 1.47 (CI, 0.62 to 3.52; P = 0.38) and for unfavorable outcome was 1.10 (CI, 0.75 to 1.63; P = 0.62). The findings of our study indicate that meropenem is an effective empirical treatment option for adults with community-acquired ABM. However, to spare carbapenems, guidelines should continue to recommend third-generation cephalosporins as an empirical treatment for the majority of patients with ABM.

Cefuroxime Treatment Failure and Haemophilus influenzae Meningitis: Case Report and Review of Literature

PEDIATRICS ◽  
1989 ◽  
Vol 84 (1) ◽  
pp. 132-135
Author(s):  
MOSHE ARDITI ◽  
BETSY C. HEROLD ◽  
RAM YOGEV
Keyword(s):  
Case Report ◽  
Bacterial Meningitis ◽  
Haemophilus Influenzae ◽  
Subdural Effusion ◽  
Third Generation ◽  
Review Of Literature ◽  
Single Drug ◽  
Days Of Therapy ◽  
Meningitis In Children ◽  
Third Generation Cephalosporins

Bacterial meningitis continues to be a major cause of morbidity and mortality in children despite effective antimicrobial therapy. Ampicillin and chloramphenicol have been the treatments of choice for bacterial meningitis in children older than 3 months of age, but recommendations also include cefuroxime and third-generation cephalosporins as possible single-drug alternatives. Although cefuroxime has been reported to be as effective as conventional therapy and some have recommended it for treatment of bacterial meningitis in children, there have been recent concerns about its efficacy. The purpose of this report is to describe an infant who had a relapse of Haemophilus influenzae meningitis 1 day after completing 30 days of therapy with iv cefuroxime for H influenzae meningitis complicated by sterile subdural effusion and possible osteomyelitis.

scholarly journals The Epidemiology of Meningitis in Infants under 90 Days of Age in a Large Pediatric Hospital

2021 ◽  
Vol 9 (3) ◽  
pp. 526
Author(s):  
Timothy A. Erickson ◽  
Flor M. Munoz ◽  
Catherine L. Troisi ◽  
Melissa S. Nolan ◽  
Rodrigo Hasbun ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Bacterial Infections ◽  
Group B Streptococcus ◽  
Significant Risk ◽  
Viral Meningitis ◽  
Third Generation ◽  
Gram Negative ◽  
E Coli ◽  
Group B ◽  
Third Generation Cephalosporins

Background: Meningitis is associated with substantial morbidity and mortality, particularly in the first three months of life. Methods: We conducted a retrospective review of patients <90 days of age with meningitis at Texas Children’s Hospital from 2010–2017. Cases were confirmed using the National Healthcare Safety Network (NHSN) definition of meningitis. Results: Among 694 infants with meningitis, the most common etiology was viral (n = 351; 51%), primarily caused by enterovirus (n = 332; 95%). A quarter of cases were caused by bacterial infections (n = 190; 27%). The most common cause of bacterial meningitis was group B Streptococcus (GBS, n = 60; 32%), followed by Gram-negative rods other than E. coli (n = 40; 21%), and E. coli (n = 37; 19%). The majority of Gram-negative organisms (63%) were resistant to ampicillin, and nearly one-fourth of Gram-negative rods (23%) other than E. coli and 2 (6%) E. coli isolates were resistant to third-generation cephalosporins. Significant risk factors for bacterial meningitis were early preterm birth and the Black race. Conclusions: Enteroviruses most commonly caused viral meningitis in infants; GBS was the most common bacterial cause despite universal screening and intrapartum prophylaxis. The emergence of MRSA and resistance to third-generation cephalosporins in Gram-negative bacterial meningitis challenges the options for empirical antimicrobial therapy.

Treatment of Gram-Negative Bacterial Meningitis in Term Neonates with Third Generation Cephalosporins plus Amikacin

2000 ◽  
Vol 77 (3) ◽  
pp. 139-146 ◽  
Author(s):  
H.D. Dellagrammaticas ◽  
Ch. Christodoulou ◽  
E. Megaloyanni ◽  
M. Papadimitriou ◽  
J. Kapetanakis ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Third Generation ◽  
Term Neonates ◽  
Gram Negative ◽  
Third Generation Cephalosporins

scholarly journals The role of prophylactic antibiotics in hepatitis B virus-related acute-on-chronic liver failure patients at risk of bacterial infection: a retrospective study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Xiao-Qin Liu ◽  
Xue-Yun Zhang ◽  
Yue Ying ◽  
Jian-Ming Zheng ◽  
Jian Sun ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Clinical Course ◽  
Prophylactic Antibiotics ◽  
Third Generation ◽  
Chronic Liver Failure ◽  
Free Survival ◽  
B Virus ◽  
Third Generation Cephalosporins

Abstract Background Acute-on-chronic liver failure (ACLF) is characterized by an excessive systemic inflammatory response and organ failure and has high mortality. Bacterial infections (BIs) worsen the clinical course of ACLF and carry a poor prognosis in ACLF patients. The efficacy of third-generation cephalosporins has been challenged in recent years. The aim of this study was to characterize the difference between ACLF patients with and without BIs and to provide a reference for medical intervention. Methods A total of 140 patients with hepatitis B virus-related ACLF (HBV-ACLF) hospitalized at the Department of Infectious Diseases, Huashan Hospital, Fudan University (Shanghai, China) between May 2013 and January 2020 were enrolled. Mann-Whitney U test was used to compare the baseline characteristics of HBV-ACLF patients with and without BIs. Univariate and multivariate analyses were performed to find predictors of BIs. The characteristics of BIs and the role of prophylactic antibiotics were profiled. Results A total of 97 episodes of BIs occurred in patients during the course of HBV-ACLF. Patients with and without BIs differed in clinical characteristics. The incidence of BIs showed a positive correlation with the ACLF grade (P = 0.003) and the clinical course (P = 0.003). The 90-day transplant-free survival of patients with BIs was lower than those without BIs (P < 0.0001). Patients administered prophylactic antibiotics showed a lower incidence of BIs and had a higher transplant-free survival probability than those who did not (P = 0.046). No statistical differences in antibiotic efficacy between third-generation and other antibiotics were observed (P = 0.108). Conclusions BIs affected the clinical course and prognosis of patients with HBV-ACLF. Prophylactic antibiotics were of potential clinical importance in the prevention of BIs and improving the clinical course and prognosis in HBV-ACLF patients. Third-generation cephalosporins were qualified for use in antibiotic prophylaxis.

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