Prospective study of "door to needle time" in meningococcal disease.
OBJECTIVE
To measure the promptness of antibiotic treatment in children with meningococcal disease.


METHODS
"Door to needle time" for parenteral antibiotics in children with meningococcal disease was recorded prospectively as part of a larger study. The time from arrival at hospital until the first dose of parenteral antibiotics was recorded in 100 children with meningococcal disease (median (range) age 21 (3-168) months) admitted to four Merseyside hospitals.


RESULTS
Forty five children presented directly to the accident and emergency (A&E) department. Parenteral penicillin was given before admission to 19 of the 55 children referred by general practitioners (GPs). Median door to needle time was 36 minutes. All children with a typical petechial rash on arrival received antibiotics within 60 minutes. Antibiotics were given sooner to those with severe disease (p = 0.01) and later to those without a rash (p = 0.007).


CONCLUSIONS
The first dose of parenteral antibiotics for most children with meningococcal disease was given in A&E. When awareness of meningococcal disease is heightened by ongoing research, those with a petechial rash are treated within 60 minutes. Strategies to improve immediate treatment of meningococcal disease should include education of A&E staff as well as GPs.
Institute of Child Health, University of Liverpool.
F A
FA
Riordan
A P
AP
Thomson
J A
JA
Sills
C A
CA
Hart
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D007263:Infusions, Parenteral; D008297:Male; D008589:Meningococcal Infections / Q000188:drug therapy* / Q000401:mortality; D009345:Neisseria meningitidis / Q000302:isolation & purification; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D010406:Penicillins