[Therapeutic management of purulent meningitis in children. Report of 101 cases].
One hundred and one cases of purulent meningitis without any sign of immediate severity have been prospectively treated. Cefotaxime was given until the results of bacteriological tests; when possible, a randomisation separated one group in which cefotaxime was continued and another group in which cefotaxime was replaced by ampicillin. IV treatment was stopped at the 10th day even in cases with persisting fever. All patients less than or equal to 2 years of age were given phenobarbitone. Serious complications consisted of 4 cases of hypoacousia, equally distributed in either therapeutic group of Haemophilus meningitis. No child developed convulsions when receiving phenobarbitone. Late examination of CSF was uncontributive, even in patients with persisting fever. The following simplifications could be proposed in purulent meningitis with usual clinical picture and course: initial treatment with IIIrd generation cephalosporin; substitution by ampicillin or amoxicillin as soon as bacteriological tests make it possible; discontinuation of IV treatment by the 10th day maximum, without CSF control; prevention of convulsions in young children by phenobarbitone given during the acute stage of meningitis.
D000658:Amoxicillin / Q000627:therapeutic use; D000667:Ampicillin / Q000627:therapeutic use; D002439:Cefotaxime / Q000627:therapeutic use; D002675:Child, Preschool; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D008581:Meningitis / Q000134:cerebrospinal fluid / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D008583:Meningitis, Haemophilus / Q000134:cerebrospinal fluid / Q000150:complications / Q000188:drug therapy; D011446:Prospective Studies; D012640:Seizures / Q000209:etiology
D000667:Ampicillin; D000658:Amoxicillin; D002439:Cefotaxime
Modalités thérapeutiques des méningites purulentes de l'enfant. A propos de 101 observations.