Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis.

Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis. Abstract Text:

K Prasad,A Kumar,P K Gupta,T Singhal,K Prasad,A Kumar,P K Gupta,T Singhal,

BACKGROUND: Antibiotic therapy for suspected acute bacterial meningitis (ABM) needs to be started immediately, even before the results of cerebrospinal fluid (CSF) culture and antibiotic sensitivity are available. Immediate commencement of effective treatment using the intravenous route may reduce death and disability. Although bacterial meningitis guidelines advise the use of third generation cephalosporins, these drugs are often not available in hospitals in low income countries. OBJECTIVES: The objective of this review was to compare the effectiveness and safety of third generation cephalosporins and conventional treatment with penicillin or ampicillin-chloramphenicol in patients with community-acquired ABM. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 1) which contains the Cochrane Acute Respiratory Infections Group Trials Register, MEDLINE (January 1966 to March 2007), and EMBASE (January 1974 to March 2007). We also searched the reference list of review articles and book chapters, and contacted experts for any unpublished trials. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing ceftriaxone or cefotaxime with conventional antibiotics as empirical therapy for acute bacterial meningitis. DATA COLLECTION AND ANALYSIS: Two review authors independently applied the study selection criteria, assessed methodological quality, and extracted data. MAIN RESULTS: Nineteen trials that involved 1496 patients were included in the analysis. There was no heterogeneity of results among the studies in any outcome except diarrhoea. There was no statistically significant difference between the groups in the risk of death (risk difference (RD) 0%; 95% confidence interval (CI) -3% to 2%), risk of deafness (RD -4%; 95% CI -9% to 1%), or risk of treatment failure (RD -1%; 95% CI -4% to 2%). However, there were significantly decreased risks of culture positivity of CSF after 10 to 48 hours (RD -6%; 95% CI -11% to 0%) and statistically significant increases in the risk of diarrhoea between the groups (RD 8%; 95% CI 3% to 13%) with the third generation cephalosporins. The risk of neutropaenia and skin rash were not significantly different between the two groups. However, all the studies were conducted in the 1980s except three, which were reported in 1993, 1996, and 2005. AUTHORS' CONCLUSIONS: The review shows no clinically important difference between ceftriaxone or cefotaxime and conventional antibiotics. In situations where availability or affordability is an issue, third generation cephalosporins, ampicillin-chloramphenicol combination, or chloramphenicol alone may be used as alternatives. The antimicrobial resistance pattern against various antibiotics needs to be closely monitored in low to middle income countries as well as high income countries.

Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis. Publishing Authors By Initials

K Prasad,A Kumar,PK Gupta,T Singhal,K Prasad,A Kumar,PK Gupta,T Singhal,

For similar abstracts research abstracts see: abstracts research

PUBMED ID PMID:

MEDLINE DATE:

Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis. Journal Published:

PUBLICATION TYPE: Review

Journal: Cochrane database of systematic reviews (Online)

VOLUME:

Page Numbers: CD001832

Journal Abbreviation:

ISSN: 1469-493X

DAY: 17

MONTH: 10

YEAR: 2007

Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis. Information

Number of References: 55

LANGUAGE: eng

NlmUniqueID: 100909747

Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis. Keywords Mesh Terms:

KEYWORDS:

MESH TERMS:

Chemical & Substance for Abstract: Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis. Information

Substance Name:

Registry Number:

Grant and Affiliation Information for Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis.

AFFILIATION: All India Institute of Medical Sciences, Neurosciences Center, Room No. 704, AIIMS, New Delhi, India, 11002. drkameshwarprasad@yahoo.co.in

Country: England

AGENCY:

GRANT:

ACRONYM:

MEDLINETA: Cochrane Database Syst Rev

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis Related Publications

• Aldosterone promotes proximal tubular cell apoptosis: role of oxidative stress.
• Analysis of paediatric injuries related to child restraint seats: are children at higher risk of injury outside the vehicle than inside?
• Changes in alcohol dehydrogenase activity, NADH and ADP levels in rats induced by stress.
• Comment on Butt et al.: Management of unstable thoracolumbar spinal injuries by posterior short segment spinal fixation.
• Comment on Shetty et al.: Ipsilateral hip and femoral shaft fractures treated with intramedullary nails.
• Ct12 surgical management of descending necrotizing mediastinitis.
• DEC-205-mediated internalization of HIV-1 results in the establishment of silent infection in renal tubular cells.
• Dialysis membrane-induced oxidative stress: role of heme oxygenase-1.
• Essay - Chaperones: are we protecting patients?
• Evaluation of the drug evaluation and classification program: a critical review of the evidence.
• Hepatocyte growth factor modulates H2O2-induced mesangial cell apoptosis through induction of heme oxygenase-1.
• High-dose chemotherapy and autologous hematopoietic stem cell transplantation in myeloma patients under the age of 65 years.
• Immobilization of Streptomyces clavuligerus on loofah sponge for the production of clavulanic acid.
• Laparotomy: still the gold standard.
• Long-term outcome of infants with positional occipital plagiocephaly.
• Media optimization for the production of beta-carotene by Blakeslea trispora: A statistical approach.
• Monoclonal gammopathy presenting as recurrent nephrotic syndrome: therapeutic implications.
• Morphine priming rescues high-dose morphine-induced biological perturbations.
• Morphine reciprocally regulates IL-10 and IL-12 production by monocyte-derived human dendritic cells and enhances T cell activation.
• Narrative review: reversible cerebral vasoconstriction syndromes.
• Primary central nervous system vasculitis: progress and questions.
• Production of cephamycin C by Streptomyces clavuligerus NT4 using solid-state fermentation.
• Production of glutaminase (E.C.3.2.1.5) from Zygosaccharomyces rouxii: Statistical optimization using response surface methodology.
• Production of schizophyllan using Schizophyllum commune NRCM.
• Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis.
• Toddler diets in the U.K.: deficiencies and imbalances. 1. Risk of micronutrient deficiencies.
• Toddler diets in the UK: deficiencies and imbalances. 2. Relationship of toddler diet to later health.
• Use of insoluble yeast beta-glucan as a support for immobilization of Candida rugosa lipase.
• Use of metabolic stimulators and inhibitors for enhanced production of beta-carotene and lycopene by Blakeslea trispora NRRL 2895 and 2896.
• Vancomycin-induced acute granulomatous interstitial nephritis: therapeutic options.