title: Imipenem/cilastatin treatment of bacterial meningitis in children.
abstract: The safety and efficacy of imipenem/cilastatin were evaluated in 21 children, ages 3 to 48 months, with bacterial meningitis. Eradication of bacteria from the cerebrospinal fluid was demonstrated within 24 hours of antibiotic therapy in all but 2 patients who had Haemophilus influenzae type b meningitis and ultimately achieved bacteriologic cure after 2 to 3 days of imipenem/cilastatin therapy. Cerebrospinal fluid penetrations of imipenem and cilastatin were determined at various times after drug administration with mean cerebrospinal fluid: serum ratios of 14 and 10% for imipenem and cilastatin, respectively. The study was terminated when 7 (33%) patients developed seizure activity after antibiotic therapy was administered. The usefulness of imipenem/cilastatin for the treatment of bacterial meningitis in children may be limited by a possible increased incidence of drug-related seizure activity.
authors.affiliation: Department of Pediatrics, Children's Hospital of Los Angeles, USC School of Medicine 90027.
authors.forename: V K
authors.initials: VK
authors.lastname: Wong
authors.forename: H T
authors.initials: HT
authors.lastname: Wright
authors.forename: L A
authors.initials: LA
authors.lastname: Ross
authors.forename: W H
authors.initials: WH
authors.lastname: Mason
authors.forename: C B
authors.initials: CB
authors.lastname: Inderlied
authors.forename: K S
authors.initials: KS
authors.lastname: Kim
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000134:cerebrospinal fluid / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D002675:Child, Preschool; D015377:Cilastatin / Q000009:adverse effects / Q000134:cerebrospinal fluid / Q000627:therapeutic use*; D000077728:Cilastatin, Imipenem Drug Combination; D004338:Drug Combinations; D005260:Female; D006801:Humans; D015378:Imipenem / Q000009:adverse effects / Q000134:cerebrospinal fluid / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D008581:Meningitis / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D008583:Meningitis, Haemophilus / Q000134:cerebrospinal fluid / Q000188:drug therapy; D008585:Meningitis, Meningococcal / Q000134:cerebrospinal fluid / Q000188:drug therapy; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D015377:Cilastatin; D015378:Imipenem; D000077728:Cilastatin, Imipenem Drug Combination