title: Association of treatment for bacterial meningitis with the development of sequelae.
abstract: BACKGROUND
  Bacterial meningitis continues to be a serious, often disabling infectious disease. The aim of this study was to assess the possibility that treatment influences the development of sequelae in childhood bacterial meningitis.
  
  
  METHODS
  Two thousand four hundred and seventy-seven patients aged 1 month to 14 years with acute bacterial meningitis over a 32-year period were enrolled in the study. Data were collected prospectively from the Meningitis Registry of a tertiary university teaching hospital in Athens, Greece. Treatment was evaluated through univariate and multivariate analysis with regard to sequelae: seizure disorder, severe hearing loss, ventriculitis, and hydrocephalus.
  
  
  RESULTS
  According to the multinomial logistic regression analysis, there was evidence that penicillin, an all-time classic antibiotic, had a protective effect on the occurrence of ventriculitis (odds ratio (OR) 0.17, 95% confidence interval (CI) 0.05-0.60), while patients treated with chloramphenicol had an elevated risk of ventriculitis (OR 17.77 95% CI 4.36-72.41) and seizure disorder (OR 4.72, 95% CI 1.12-19.96). Cephalosporins were related to an increased risk of hydrocephalus (OR 5.24, 95% CI 1.05-26.29) and ventriculitis (OR 5.72, 95% CI 1.27-25.76). The use of trimethoprim/sulfamethoxazole increased the probability of seizure disorder (OR 3.26, 95% CI 1.08-9.84) and ventriculitis (OR 8.60, 95% CI 2.97-24.91). Hydrocortisone was associated with a rise in hydrocephalus (OR 5.44, 95% CI 1.23-23.45), while a protective effect of dexamethasone (OR 0.82, 95% CI 0.18-3.79) was not statistically significant.
  
  
  CONCLUSIONS
  Current study findings suggest that the type of antimicrobial treatment for childhood bacterial meningitis may influence in either a positive or a negative way the development of neurological sequelae.
authors.affiliation: Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str, 41222, Larissa, Greece.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Theodoridou
authors.forename: Vasiliki A
authors.initials: VA
authors.lastname: Vasilopoulou
authors.forename: Anna
authors.initials: A
authors.lastname: Katsiaflaka
authors.forename: Maria N
authors.initials: MN
authors.lastname: Theodoridou
authors.forename: Violeta
authors.initials: V
authors.lastname: Roka
authors.forename: George
authors.initials: G
authors.lastname: Rachiotis
authors.forename: Christos S
authors.initials: CS
authors.lastname: Hadjichristodoulou
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D006115:Greece; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016920:Meningitis, Bacterial / Q000150:complications* / Q000188:drug therapy* / Q000382:microbiology; D009026:Mortality; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology*; D012042:Registries
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents
keywords: Bacterial meningitis; Child; Prognosis; Sequelae; Treatment