Cefuroxime in bacterial meningitis

Abstract

In order to find an alternative antimicrobial treatment for childhood bacterial meningitis 30 infants and children with meningitis, due to Haemophilus influenzae (n = 13), Neisseria meningitis (n = 9), Streptococcus pneumoniae (n = 5), or meningitis of unknown aetiology (n = 3), were treated with cefuroxime, 200 mg/kg a day, as the only antibiotic. Prompt clinical and bacteriological responses were noted and every patient was cured. Cefuroxime concentrations in cerebrospinal fluid ranged from 1.1 to 18.8 (mean 7.0) mg/l at the beginning and from 0.5 to 4.1 (mean 1.6) mg/l at the end of treatment. Three infants developed symptomatic sterile subdural effusions which were managed by repeated subdural aspirations while still on antibiotics. Cefuroxime concentrations in the subdural fluid ranged from 17.4 to 32.4 mg/l. At follow-up 2 patients had moderate unilateral hearing loss and one had mild ataxia. We conclude that cefuroxime is effective and safe for the treatment of childhood bacterial meningitis caused by any of these common organisms.