Childhood bacterial meningitis in Mbarara Hospital; Uganda: antimicrobial susceptibility and outcome of treatment
Kiwanuka, Julius P; Mwanga, Juliet.
Afr. health sci. (Online)
; 1(1): 9-15, 2002.
Artículo
en Inglés
| AIM | ID: biblio-1256392
The recommended antibiotic treatment of bacterial meningitis has come under scrutiny following frequent reports of in-vitro resistance by the common causative organisms to penecillin and chloramphenicol.
Objective:
the study recorded the causative organisms; antibiotic sensitivity patterns and outcome of treatment of bacterial meningitis in children and examined the impact of various factors on the recorded outcome.Design:
this was a retrospective review of all case records of patients treated for bacterial meningitis over a one-year period.Setting:
The study was set in the paediatric wards of Mbarara University Teaching Hospital; in South Western Uganda.Results:
A total of 77 patients were treated. Among 56 patients with available CSF results the frequency of bacterial causes was as follows H.influenzae 13(23.2); coliforms 7(12.5); uncultured Gram-negative bacilli 7)12.5); S. pneumoniae 5(8.9) and N. meningitids 3(5.4). Most isolates tested were resistant to both penicillin and chloramphenicol; but all were sensitive to ciptofloxacin and perfloxacin. Twenty eight (36.8) patients died; 22(28.9) survived with sequelae and 15(19.7) improved without sequaelae. 14/18 who received perfloxacin and/or ciprofloxacin survived comapred with 23/47 who did not p=0.04).Conclusions:
The high case-fatality rates and the high frequency of resistance to penicillin and chloramphenicol make a case for a review of the currently recommended antibiotic treatment of bacterial meningitis in this region. Fluoroquinolones need further evaluation as potential alternatives to chloramphenicol in the treatment of bacterial meningitis
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CG1.1
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