Comparison of Efficacy of Short-Term Versus Conventional Antibiotic Regimen in Treatment of Neonatal Pyogenic Meningitis

Abstract

Objective Conventional regimen for treating neonatal pyogenic meningitis is parenteral antibiotics for 21 days. We compared efficacy of short-term antibiotic of 14 days to this conventional regimen. Methods A quasi-experimental study was conducted in tertiary care hospital over 11 months. Neonates having birth-weight more than 1.5 kg with pyogenic meningitis were enrolled, and allotted into 2 groups: group A was given antibiotics for 14 days and group B for 21 days. They were monitored during hospital stay, and compared on follow-up on day 28. Primary outcome measure was treatment failure in the form of recurrence of sepsis/meningitis and faltering in growth or developmental milestones. Results The treatment success rate in both groups was 100%, no patient had recurrence. Mean growth in head circumference on day 28 was 1.8 (±0.56) cm in group A and 1.62 (±0.56) cm in group B, P = .15. Mean weight gain was 540 (±230) gm in group A and 470 (±180) gm in group B, P = .13. Mean length gain was 2.51 (±0.95) cm in group A and 2.33 (±0.64) cm in group B, P = .32. On day 28, all patients of group A and B had achieved social smile ( P = 1.0), 34 from group A and 38 from group B achieved gaze fixation ( P = .37), 21 from group A and 18 from group B could hold head steady ( P = 1.0). None developed any sequalae or abnormal otoacoustic emissions. Conclusion Short course of antibiotics for neonatal pyogenic meningitis was as effective as the conventional regimen in neonates with cerebrospinal fluid clearance and clinical improvement by day 7.