Περίληψη:
The aim of this retrospective study was to evaluate the clinical
efficacy in terms of mortality and long-term morbidity of third
generation cephalosporins and amikacin in combination for the treatment
of gram-negative bacterial meningitis in a homogeneous group of
neonates, A 15-year experience (1983-1997) with 72 term neonates without
central nervous system anomalies and with gramnegative organisms grown
in their cerebrospinal fluid treated with the above combination of
antibiotics is presented. All isolated organisms were sensitive to
cefotaxime or ceftazidime and to amikacin but 80% were resistant to
ampicillin, The predominant infecting organism was Escherichia coli
(68.0%) which was sensitive to both cefotaxime and amikacin in all
cases but resistant to ampicillin in 48% of cases. Survival at
discharge was 97.2% but ultimate survival was reduced to 94.4%, as 2
patients died a few months following discharge of conditions unrelated
to meningitis. Ventriculitis was diagnosed in 10 neonates (13.8%).
Among survivors, 1 neonate (1.3%) developed hydrocephalus needing
shunting and 1 neonate (1.3%) with Proteus mirabilis developed a brain
abscess with relapse of meningitis which was successfully treated with a
6-week course of chloramphenicol. At follow-up at an age greater than 6
months, 91.1% of the surviving infants were normal, while 92.3% of
survivors at an age greater than 6 years were normal and attended normal
school. These results, despite any reservations due to the nature of the
study (retrospective, uncontrolled study), strongly support the use of
third generation cephalosporins and amikacin in combination for the
treatment of neonatal gram-negative bacterial meningitis, Copright (C)
2000 S.Karser AG, Basel.
Συγγραφείς:
Dellagrammaticas, HD
Christodoulou, C
Megaloyanni, E and
Papadimitriou, M
Kapetanakis, J
Kourakis, G
