Ceftriaxone is effective in meningococcal meningitis
According to a study published in the July issue of Lancet, in the treatment of epidemic meningococcal meningitis, a single administration of ceftriaxone is as effective as the administration of a prolonged form of chloramphenicol under form of oil suspension.
According to the recommendations of the World Health Organization, an oily suspension with prolonged release of chloramphenicol can be used in the short term during massive epidemics of meningococcal meningitis. In this regard, chloramphenicol should be prescribed during epidemics of meningococcal infection and when other forms of antibiotic therapy are ineffective.
According to French scientists, a single intramuscular injection of ceftriaxone at a dose of 100 mg / kg, at a maximum daily dose of up to 4 g, had clinical efficacy comparable to a single intramuscular injection of an oily suspension of chloramphenicol at a dose of 100 mg / kg, a maximum daily dose of up to 3 g, with treatment of Neisseria meningitides epidemic meningitis in eastern Nigeria.
In 2003, a randomized open-label study of two antimicrobials, ceftriaxone and chloramphenicol, was conducted in Nigeria to treat suspected bacterial meningitis in people over 2 months of age. The patients were divided into 2 groups: 247 people were included in the group of patients receiving ceftriaxone, 256 people were included in the chloramphenicol treatment group. The main outcome measure was treatment failure, defined as death of the patient or clinical failure 72 hours after the start of treatment.
A fatal outcome was recorded in 5% of patients on chloramphenicol and in 6% of patients on ceftriaxone; clinical treatment failure was observed in 4% and 3% respectively. Neurological symptoms of meningitis after 72 hours persisted in 5% and 7% of cases, respectively.
In a multiple regression analysis of the results, it was found that the reliable risk factors for the development of clinical ineffectiveness during the first 72 hours were loss of consciousness at the onset of illness and the presence of another condition. concurrent. There was no evidence of a relationship between the risk of clinical failure of ceftriaxone treatment.
Researchers believe that high efficiency, ease of use in epidemics, pronounced activity against pathogens such as Streptococcus pneumoniae, affordability and low cost are strong arguments to use ceftriaxone as a first-line medicine for the treatment of epidemic meningococcal meningitis.