title: Three days of intravenous benzyl penicillin treatment of meningococcal disease in adults.
abstract: New Zealand has experienced an epidemic of predominantly serogroup B meningococcal disease during the past decade. In a prospective study, we treated adults (age, >15 years) with meningococcal disease with intravenous benzyl penicillin (12 MU [7.2 g] per day) for 3 days. Sixty-one adults with suspected meningococcal disease were consecutively admitted during the 33-month period; 3 patients were excluded. The 58 patients had a mean age (+/- standard deviation [SD]) of 27.9+/-14.5 years (median, 21 years; range, 15-70 years). Forty-four patients had confirmed and 14 patients had probable meningococcal disease. Fifty-seven patients received 12 MU (7.2 g) and 1 received 8 MU (4.8 g) of benzyl penicillin per day. Thirteen patients received additional antibiotics within the first 24 h because of diagnostic uncertainties. Patients received a mean (+/-SD) of 3.0+/-0.5 days of treatment. No patients relapsed. Five patients died. All but 1 death occurred during benzyl penicillin treatment, and the only posttreatment death was not due to meningococcal disease. Three days of intravenous benzyl penicillin is sufficient treatment for adults with meningococcal disease. The usual recommendations for duration of treatment are excessive.
authors.affiliation: Department of Infectious Diseases, Auckland Hospital, Auckland, New Zealand. RodEP@adhb.govt.nz
authors.forename: Rod
authors.initials: R
authors.lastname: Ellis-Pegler
authors.forename: Lesley
authors.initials: L
authors.lastname: Galler
authors.forename: Sally
authors.initials: S
authors.lastname: Roberts
authors.forename: Mark
authors.initials: M
authors.lastname: Thomas
authors.forename: Andrew
authors.initials: A
authors.lastname: Woodhouse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008589:Meningococcal Infections / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D008826:Microbial Sensitivity Tests / Q000379:methods; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000187:drug effects; D009345:Neisseria meningitidis / Q000187:drug effects / Q000302:isolation & purification; D009520:New Zealand; D010400:Penicillin G / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D010400:Penicillin G