One hundred and sixty cases of acute
bacterial meningitis were treated with
cefotaxime. Patients were between 9 days and 79 years old: 7 new borns, 37 infants, 43 children, 19 adolescents and 54 adults. Fifty-eight patients (36%) were in
coma when admitted. Aetiology was determined in 110 patients (68.8%): Neisseria meningitidis in 42, Streptococcus pneumoniae in 36, Haemophilus influenzae in 16, Salmonella spp. in 7, Staphylococcus aureus in 2, Enterobacter spp. in 2 and Haemophilus parainfluenzae, pseudomonas aeruginosa, Escherichia coli, Citrobacter freundii and Klebsiella pneumoniae in one patient each. All isolates were sensitive to
cefotaxime, with MIC's for 26 strains ranging from 0.01 to 0.50 mg/l. One hundred and fifty-six of the 160 patients were treated with
cefotaxime alone and the four others with
cefotaxime in association with an
aminoglycoside in three and
rifampicin in one.
Cefotaxime was administered by
intravenous infusion, in a daily dose 100 to 300 mg/kg.
Duration of treatment ranged from 8 days to 6 weeks, with a mean of 15 days. One hundred and forty-nine patients (93.1%) were cured, two after a relapse. Three patients had sequelae. Most (88.5%) had sterile CSF within 72 h after starting treatment. Eleven patients (6.9%) died, eight within the first 48 h. The only side-effects observed were mild transient
eosinophilia in some patients and
rash and
leukopenia in 2 each. The study demonstrates that
cefotaxime is effective in the treatment of acute
bacterial meningitis.