Delayed cerebrospinal fluid sterilization in infants with Hemophilus influenzae type b meningitis.
Cerebrospinal fluid (CSF) sterilization after greater than 24 h of intravenous antibiotic therapy (delayed CSF sterilization) was noted in two infants treated with ceftizoxime and ceftazidime for bacterial meningitis. A case-control study was conducted of children between 6 w and 6 y of age treated between 1975 and 1985 at one institution for bacterial meningitis to determine risk factors for delayed CSF sterilization. Hemophilus influenzae type b was isolated from all children (n = 5) with delayed CSF sterilization, compared with only 78% of all children in the study (n = 83). In children with H. influenzae type b disease, children less than 6 mo of age were at higher risk than older children for delayed CSF sterilization (odds ratio = 7.5, 95% confidence limits = 1.4, 40.0). Factors not associated with delayed CSF sterilization included time of follow-up lumbar puncture, CSF total or differential white blood cell count, and CSF protein and glucose concentrations. Despite the in vitro antimicrobial susceptibility of H. influenzae type b to ceftizoxime and ceftazidime, delayed CSF sterilization may occur in infants receiving these antibiotics for bacterial meningitis.
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Communicable Disease Service, Los Angeles County Hospital-University of Southern California Medical Center.
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D000367:Age Factors; D000667:Ampicillin / Q000134:cerebrospinal fluid / Q000494:pharmacology / Q000627:therapeutic use*; D002228:Carbenicillin / Q000134:cerebrospinal fluid / Q000494:pharmacology / Q000627:therapeutic use*; D016022:Case-Control Studies; D002442:Ceftazidime / Q000134:cerebrospinal fluid / Q000494:pharmacology / Q000627:therapeutic use*; D015296:Ceftizoxime / Q000134:cerebrospinal fluid / Q000494:pharmacology / Q000627:therapeutic use*; D002675:Child, Preschool; D002701:Chloramphenicol / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006193:Haemophilus influenzae / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D008583:Meningitis, Haemophilus / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D012307:Risk Factors
D002701:Chloramphenicol; D000667:Ampicillin; D002442:Ceftazidime; D015296:Ceftizoxime; D002228:Carbenicillin