Antibiotic therapy of meningitis caused by ampicillin-resistant Haemophilus influenzae in Denmark and Greenland 1981 to 1987.
A survey was performed in Denmark and Greenland in order to determine whether the current recommendation of ampicillin (400 mg/kg/day) for initial treatment of purulent meningitis is appropriate. Data obtained 1981-1987 in an ongoing nationwide programme for surveillance of ampicillin-resistant Haemophilus species was analysed, and patient records of 21 cases of meningitis caused by ampicillin-resistant Haemophilus influenzae strains (17 in Denmark, 4 in Greenland) reported in the period 1981-1987 were reviewed. In Denmark the overall rate of ampicillin-resistant Haemophilus influenzae was estimated to be approximately 2% for the study period, and the average rate of resistant isolates from spinal fluid was 5.2% (range 0-12.3%). The incidence of meningitis caused by ampicillin-resistant Haemophilus influenzae strains remained low in the Danish population (around 0.05/100,000/year) except for a peak in 1985. The overall mortality rate of Haemophilus influenzae meningitis for the study period was 2.4%, which was the same as before 1980. In Greenland the actual number of cases of meningitis caused by ampicillin-resistant Haemophilus influenzae was small, but the incidence was at least 40 to 80 times higher than in Denmark with a high mortality rate (50%). These observations prompted revision of the antibiotic regimen in Greenland, whereas the regimen was considered appropriate in Denmark.
D000328:Adult; D000667:Ampicillin / Q000494:pharmacology / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003718:Denmark; D006116:Greenland; D006193:Haemophilus influenzae / Q000187:drug effects*; D006801:Humans; D007223:Infant; D008583:Meningitis, Haemophilus / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D010403:Penicillin Resistance; D012189:Retrospective Studies; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000667:Ampicillin