Outcome of Bacterial Meningitis in Children age 1 Month – 12 Years in a Public st SectorHospital Treated with 1 line Antibiotics

Abstract

Objective: To determine the effectiveness of using first line antibiotics for the treatment of acute bacterial meningitis in children admitted in a public sector hospital and assessing its outcome with the help of data by need for using second line antibiotics therapy and length of stay in hospital. Method: This Crosssectional study was conducted at department of Pediatrics, Pakistan Institute of Medical Sciences, Islamabad over a period of 6 months from January 2019 to July 2019. All children between the age of 1 month – 12 years, of both genders admitted in pediatric ward with acute bacterial meningitis, based on clinical features plus CSF findings, were enrolled in the study. These children were started with first line antibiotic therapy after admission in ward which included ceftriaxone alone or a combination of ampicillin and cefotaxime or cefotaxime plus amikacin depending on age specific recommendations for that age group. All children were closely observed in ward for improvement or deterioration of symptoms. If there was deterioration of symptoms, then second line antibiotics were started which in our case was vancomycin combined with ceftriaxone or meropenem combined with vancomycin. Duration of hospital stay was also noted. Data was analyzed by SPSS version 22. Results: A total of 51 patients were enrolled in the study. Mean age of children in the study was 3.23 ± 3.3 years. There were 33(65.1%) males and 18(34.9%) females. Only 30(58.6%) children were completely vaccinated, rest were either partially vaccinated or not vaccinated at all. ]In the first line antibiotics course, ceftriaxone was the most common antibiotic, which was prescribed to 32(61.3%) children, followed by a combination of cefotaxime with amikacin 13(23.7%) and ampicillin plus cefotaximeto 6(4.3%). Second line therapy was needed in only15(29%) children. The commonly prescribed was a combination of vancomycin and meropenem. The total duration of stay in hospital was for 10-14 days. Conclusion: Our study concluded that first line antibiotic therapy is still an effective treatment for acute bacterial meningitis. So, in the wake of emerging antibiotic resistance, irrational use of antibiotics should be avoided.