A comparison of ceftriaxone and cefuroxime for the treatment of bacterial meningitis in children

Article Abstract:

Bacterial infections sometimes occur in the membranes surrounding the brain and spinal cord, the meninges. In children, bacterial meningitis causes a substantial number of deaths and lingering or permanent complications. Bacterial meningitis can usually be successfully treated with the antibiotic chloramphenicol. However, the drug's side effects and resistance of some organisms to the drug have stimulated experimental evaluation of other drugs. Several new drugs belonging to the cephalosporin class of antibiotics have been compared with chloramphenicol. The cephalosporins allow rapid entry of the drug into the fluid surrounding the brain, known as the cerebrospinal fluid, and cause few side effects. The effectiveness of two different cephalosporins, ceftriaxone and cefuroxime, was compared. A group of 106 children, aged between 42 days and 16 years, with bacterial meningitis were divided into two experimental groups, each receiving one of the drugs. Spinal taps were taken between 18 and 36 hours after initiation of drug therapy and the fluid obtained was cultured for the presence of bacteria. At that time the number of children in the ceftriaxone-treated group with bacteria in their cerebrospinal fluid was 1 out of 52, compared with 6 out of 52 in the cefuroxime-treated group. Although the sterilization of the cerebrospinal fluid occurred more rapidly in the children treated with ceftriaxone, 35 of them developed a form of false gallstone on account of excretion of the drug through the liver. These stones rapidly dissolved following treatment and caused no permanent difficulty. Some children in both groups developed hearing losses as a result of bacterial infections of their inner ears, which were significantly less frequent among ceftriaxone-treated children. Although all children of both groups recovered from their meningitis, the use of ceftriaxone is superior to cefuroxime for the treatment of bacterial meningitis in children. (Consumer Summary produced by Reliance Medical Information, Inc.)

Pediatric diseases, Cefuroxime, Ceftriaxone, Ceftriaxone sodium

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Brief report: disseminated osteomyelitis from Mycobacterium ulcerans after a snakebite

Article Abstract:

A child developed osteomyelitis after developing an infection caused by Mycobacterium ulcerans following a snakebite. Osteomyelitis is inflammation of the bone marrow and the adjacent bone. The child had developed gangrene after being bitten on his right leg by a snake. He had his right foot amputated two months after being bitten and subsequently part of his right leg was amputated. Despite treatment with antibiotics, he continued to develop bone lesions on his arms and legs and skin lesions on his chest, arms and legs. He was readmitted to the hospital for treatment. A tuberculin skin test was positive, and microscopic examination of smears of bone tissue revealed that he had mycobacterial osteomyelitis. He was treated with a combination of co-trimoxazole, rifampin and ethambutol.

Case studies, Complications and side effects, Mycobacterial infections, Mycobacterium infections, Bites and stings, Bites (Injuries), Stings (Injuries), Osteomyelitis

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Dexamethasone as adjunctive therapy in bacterial meningitis: a meta-analysis or randomized clinical trials since 1988

Article Abstract:

Dexamethasone given in combination with antibiotics may be beneficial in treating bacterial meningitis but it should only be given for 2 days. Bacterial meningitis is an infection of the membrane surrounding the brain and can be caused by Hemophilus influenzae type b or Streptococcus pneumoniae. Researchers evaluated 11 clinical trials of dexamethasone in the treatment of bacterial meningitis. The drug reduced severe hearing loss and may be effective in preventing other neurological complications. Two days of therapy appeared to be optimal because longer treatment increases the risk of side effects.

Health aspects, Dexamethasone

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