A retrospective cohort study comparing the cure rates of ampicillin, chloramphenicol, ampicillin and chloramphenicol combination, and third generation cephalosporins as initial antibiotic therapy for invasive Haemophilus influenzae infections

ABSTRACT

Background/Objective@#Haemophilus influenzae type b remains to be a significant etiology of invasive infections specially in children two months to five years old without Hib vaccination. This study was performed to compare the cure rates of ampicillin, chloramphenicol, ampicillin-chloramphenicol combination and third generation cephalosporins as initial antibiotic treatments for documented invasive Hib infections. This study may assist in formulating recommendations on empiric antimicrobial therapy. @*Methods@#Charts of patients with invasive Hib disease confirmed either by blood culture, CSF culture and/or latex agglutination test from January 1991 to August 2010 were reviewed. Cases were classified into four groups depending on the initial antibiotic given upon admission. The four groups were compared and analyzed in terms of cure rates. @*Results@#The disease occurred predominantly in children less than two years old. Males were more frequently affected than females. All subjects were not given Hib vaccination. Cure rates were significantly different between ampicillin (33%) and chloramphenicol (89%) groups (p=0.017), and between chloramphenicol (89%) and ampicillin-chloramphenicol (39%) groups (p=0.008). However, cure rates were not significantly different when third generation cephalosporin group (62%) was compared to the other treatment groups (p>0.05). Resistance of Hib was 31% to ampicillin, while <10% to chloramphenicol and third generation cephalosporins. Conclusion: Chloramphenicol is an excellent drug for empiric therapy in highly suspected or proven cases of invasive Hib disease.