[Studies of treatment for Haemophilus influenzae type b meningitis in children].
We summarize 41 cases of bacterial meningitis in the last 11 years caused by Haemophilus influenzae. All isolates were serotype b strain (Hib). Initial chemotherapy was started with ceftriaxone (CTRX) in 22 cases, ampicillin plus cefotaxime (CTX) in 9, CTRX plus panipenem/betamipron in 5, and CTX in 2. Some 31 cases were treated mainly with CTRX. Although therapeutic antibiotics showed good susceptibility for isolates, 8 complicated cases (19.5%) occurred. Sequalae were observed in 7 (17.1%) but none were fatal. Five strains with elevated MIC of CTX (0.12 to 1 microg/mL) recovered after 2001, and 3 of 5 strains also showed elevated MIC of CTRX (0.12 to 0.5 microg/mL), but all were cured completely with CTRX. At present, no treatment failures due to antibiotic resistance have been observed, and CTRX remains suitable as initial therapy for Hib meningitis. A decline in susceptibility for third-generation cephalosporin against beta-lactamase-nonproducing ampicillin-resistant H. influenzae is emerging, however, so it will be necessary to consider combination therapy with CTRX given the foreseeable trend in MICs.
Hoshino
Tadashi
T
Department of Pediatrics, Chiba University Graduate School of Medicine.
Ishiwada
Naruhiko
N
Abe
Katsuaki A
KA
Ogita
Junko
J
Fukasawa
Chie
C
Sudo
Fusayo
F
Inami
Yukiko
Y
Hishiki
Haruka
H
Aizawa
Jiro
J
Ishikawa
Nobuyasu
N
Kurosaki
Tomomichi
T
Nakamura
Akira
A
Kohno
Yoichi
Y
D000667:Ampicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002439:Cefotaxime / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D019741:Haemophilus influenzae type b / Q000187:drug effects; D006801:Humans; D008297:Male; D008583:Meningitis, Haemophilus / Q000188:drug therapy*; D008826:Microbial Sensitivity Tests
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D000667:Ampicillin; D002439:Cefotaxime