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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-three infants and children with bacterial meningitis were treated intravenously with 200 mg of amoxicillin sodium per kg per day for 10 days. (Patients were initially treated with ampicillin and chloramphenicol until the bacterial etiology was defined.) Patients were randomly treated with amoxicillin only or with amoxicillin and four doses of probenecid (10 mg/kg per dose) orally every 6 h for 24 h before the lumbar puncture at day 10. Serum and cerebrospinal fluid (CSF) were obtained on days 1, 5, and 10 of therapy for antibiotic assay. The mean peak serum concentration of amoxicillin of 49.2 micrograms/ml was increased to 61.4 micrograms/ml in patients who received probenecid. The half-life in serum (1.5 h) and area under the curve with probenecid (112.5 micrograms/ml-h) were increased compared with those of amoxicillin alone (1.3 h and 82.2 micrograms/ml-h). The mean peak CSF concentrations on days 1 and 5 were similar, but day 1 concentrations remained between 2.0 micrograms/ml and 5.0 micrograms/ml throughout the 4 h after a dose, whereas the day 5 values decreased at the same decay rate as that in serum. All CSF concentrations were lower on day 10, but patients receiving probenecid had peak values occurring at 1 hr rather than at 0.5 h, and levels were significantly greater at 1 and 2 h after a dose. There were no deaths and patients responded well to treatment.
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PMID:Clinicopharmacological evaluation of amoxicillin and probenecid against bacterial meningitis. 50 89

The passage of 6-[(R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetamido)-penicillanic acid sodium salt (mezlocillin, Baypen), into the CSF was studied in 9 patients with symptoms of acute meningitis, presumed to be of viral origin. The antibiotic was given as a single 5 g dose i.v. over 30 min. The CSF/serum concentration ratio of mezlocillin showed a variation from 0 to 10.7%. The antibiotic could be effective in the treatment of bacterial meningitis caused by ampicillin-resistant strains of Haemophilus influenzae and by most Enterobacteriaceae, provided these results will be confirmed by a study now in progress. In one patient suffering from meningococcal meningitis this concentration ratio varied between 72% (day 3) and 54% (day 12).
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PMID:Cerebrospinal fluid penetration of mezlocillin. 54 3

The use of antibiotics in viral diseases of childhood is discussed. If bacterial infection is likely, either as superinfection or as part of the differential diagnosis, then antibiotics should be given. The antibiotic of choice for each illness is considered. Respiratory infections are common. The diagnosis and treatment of streptococcal pharyngitis is compared with viral pharyngitis. Penicillin is indicated if the bacterial infection is possible. If there is difficulty in distinguishing between croup and epiglottitis, then chloramphenicol or ampicillin should be given. Otitis media and pneumonia caused by viruses are difficult to differentiate from their bacterial counterparts, and antibiotics are indicated. By contrast, antibiotics are not used in bronchiolitis or asthma. Antibiotics are contraindicated in gastroenteritis even if caused by bacteria. Prolongation of the carrier state or superinfection may then occur. Interpretation of the biochemical and bacteriological findings of the cerebrospinal fluid is important in distinguishing viral meningitis and encephalitis from bacterial meningitis. If bacterial meningitis is possible, then antibiotics should be used. The indications for antibiotics in viral diseases of the skin, eye, joints, heart and parotid are also discussed.
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PMID:Antibiotics: their true place in the treatment of viral disease. 66 65

Passage of cephaloridine, cephalothin and cefazolin into cerebrospinal fluid (CSF) was evaluated in Staphylococcus aureus meningitis in rabbits and the following results were obtained. 1. Concentration in CSF (microgram/ml) [CSF/serum ratio (%)] was determined 1/2, 1 and 2 hours after a single intravenous injection of 100 mg/kg of each antibiotic, respectively; cephaloridine-7.5 [8.9], 9.7 [13.8], 9.1 [22.6]; cephalothin-0.42 [3.6], 0.23 [6.4], not detectable [0]; cefazolin-7.5 [11.8], 5.2 [19.3], 2.0 [17.5]. 2. When results with cefazolin after an intravenous injection 100 mg/kg and 200 mg/kg were compared, a definite dose response was noted in blood concentration but not in CSF concentration. 3. A standard error of CSF concentrations of each antibiotic was larger than that of penicillins, and "Unpredictability" of their passage into CSF was considered to be one of the characteristics common to these three drugs in respect of their passage into CSF. 4. There was no significant difference noted in antibiotic passage into CSF between cephaloridine of low protein binding rate and cefazolin of very high binding rate. Cephalothin, of which binding rate was intermediate, showed a remarkably lower passage into CSF. These results indicate that a correlation does not always exist between protein binding rate of the antibiotics and their passage into CSF. 5. Based on the above results, a review of the literature was made on clinical applicability of these three antibiotics in the treatment of bacterial meningitis. Low transport rate of cephalothin into CSF and nephrotoxicity of cephaloridine make them to be unsuitable for bacterial meningitis. Cefazolin is considered to be suitable in the treatment of ampicillin-resistant Escherichia coli meningitis and Gram-positive coccal meningitis in which penicillins are not applicable.
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PMID:[Experimental studies on the passage of antibiotics into cerebrospinal fluid in staphylococcal meningitis in rabbits. II. Cephaloridine, cephalothin and cefazolin (author's transl)]. 68 68

Because cerebrospinal fluid (CSF) antibiotic levels fail to predict either clinical success or relapse in the treatment of bacterial meningitis, we examined simultaneous antibiotic concentrations in the blood, brain, and CSF of control rabbits and of animals with experimental pneumococcal meningitis. Cefamandole pharmacokinetics were analyzed in detail and compared with those of cephalothin, ampicillin, penicillin G, and tobramycin. After 4 h of continuous intravenous infusion, cefamandole reached concentrations in both brain and CSF in excess of the minimal bactericidal concentration for the test organism and compared favorably with ampicillin and penicillin in achieving bacteriological cure. Cephalothin levels in the central nervous system remained undetectable in both control and infected animals during this time. Tobramycin concentrations were measurable in the CSF, but not in brain tissue in association with an inflammatory stimulus.
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PMID:Blood, brain, and cerebrospinal fluid concentrations of several antibiotics in rabbits with intact and inflamed meninges. 93 69

Antibiotic therapy of bacterial meningitis is being reevaluated due to reports of ampicillin-resistant strains of Hemophilus influenzae type b. The infant reported had a relapse of H. influenzae type b meningitis after an excellent clinical and bacteriologic response to an initial course of combined antibiotic therapy including chloramphenicol. This relapse is postulated to be due to localized cerebral vasculitis which was not treated for a sufficient period of time during the initial course of therapy. The patient responded well to a second course of penicillin and chloramphenicol. Since the use of pencillin and chloramphenicol will be increasing, the clinician should be aware that bacteriologic relapse of H. influenzae type b meningitis may occur with chloramphenicol therapy.
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PMID:Relapse of Hemophilus influenzae type b meningitis after combined antibiotic therapy: report of a case. 108 7

Thirty-seven children treated for bacterial meningitis with ampicillin in high doses were followed up with audiometric control. Defects were recorded in 6 cases. Two of these were ascribed to chronic otosalpingitis. In 4 patients with sensorineural hearing loss, 3 were unilateral, and in only one case was the damage bilateral. Even here there was a previous history of hearing loss. A suggested ototoxicity of ampicillin could not be confirmed.
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PMID:Tone audiometry control of children treated for meningitis with large intravenous doses of ampicillin. 108 98

Ten infants, 8 days to 10 months old, with meningitis and/or septicemia were considered therapeutic failures after conventional antibiotic treatment (i.e. kanamycin, ampicillin and sulfonamides) and given sulphamethoxazole and trimethoprim parenterally. Nine patients recovered, 8 of them rapidly, and one after prolonged treatment for 34 days when kanamycin was added to the combination. One infant improved but later died of complications not related to the treatment. High concentrations in serum and cerebrospinal fluid were achieved with a daily dose of 30-40 mg sulphamethoxazole and 6-8 mg trimethoprim per kg without signs of accumulation. No change in resistance of the bacteria isolated was seen. A hemolytic reaction, probably due to the propylene glycol in the solution, was seen in one case. Other possible side-effects in this age-group are discussed. The antibiotic combination used seems to be a good alternative in the therapy of bacterial meningitis of infants caused by gram-negative bacteria. However it should still not be given to icteric or very immature infants and probably not during the first week of life.
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PMID:Treatment of meningitis and septicemia in infancy with a sulphamethoxazole/trimethorpim combination. 109 Jan 7

Bacterial meningitis remains one of the most common life threatening infections of childhood. There exists a conventional therapy for this disease. However, with the increasing incidence of Haemophilus strains resistant to ampicillin and chloramphenicol and Streptococcus pneumonia strains relatively resistant to penicillin, alteration of current therapeutic regimens for meningitis may become necessary. Cephalosporins were considered as alternatives to the conventional therapy for the treatment of bacterial meningitis during the past decade. However, there are still some discrepancies on the use of these against some organisms despite the advent of the cephalosporins. Thus, a review article analyzing quite a number of reliable clinical trials related to cephalosporins for the treatment of bacterial meningitis during the past decade to date is introduced.
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PMID:Cephalosporins in childhood bacterial meningitis. 130 53

During the four years period from 1988 to 1991, 50 pediatric patients were diagnosed to have bacterial meningitis, out of a total number of 9057 pediatric admissions at Qatif Central Hospital, Qatif, Saudi Arabia, and 82% were less than two years of age. The causative organisms were isolated in 27 (54%) patients. The bacteria grown included Haemophilus influenzae type B in 8 patients (29.6%), Neisseria meningitidis in 8 patients (29.6%), Streptococcus pneumonia in 6 (22%) patients, and other bacteria in 5 patients (18.5%). Cerebro spinal fluid cultures from twenty three patients (46%) showed no organisms, however their clinical and C.S.F. findings were compatible with bacterial meningitis. One case of H. influenzae type B was resistant to ampicillin. Six patients died with an over all mortality of 12%, and 10 patients (20%) developed some kind of C.N.S. sequelae. Partially treated meningitis formed a large percentage of our sample.
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PMID:Bacterial meningitis in Saudi children. 134 Aug 60


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