Early parenteral penicillin in meningococcal disease.

Gossain, Savita; Constantine, C. E.; Webberley, J. M.

doi:10.1136/bmj.305.6852.523-c

Cited by 17 publications

(6 citation statements)

References 12 publications

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“…This is a similar proportion to that found in previous studies 10 11. The most important factor in whether children received preadmission penicillin was if the general practitioner diagnosed meningococcal disease rather than meningitis.…”

Section: Discussionsupporting

confidence: 86%

Lesson of the Week: Who spots the spots? Diagnosis and treatment of early meningococcal disease in children

Riordan

Thomson

Sills

et al. 1996

BMJ

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Section: Discussionsupporting

confidence: 86%

Lesson of the Week: Who spots the spots? Diagnosis and treatment of early meningococcal disease in children

Riordan

Thomson

Sills

et al. 1996

BMJ

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“…[23] Two studies showed a trend towards increased survival in patients given penicillin before admission, although neither achieved statistical significance (table III). [17,24] A meta-analysis of these studies, combined with one reported in the subsequent correspondence, [25] showed a significant benefit from pre-admission penicillin (table III). [26] However, a study from Denmark found a significantly higher mortality amongst those given early penicillin.…”

Section: Treatmentmentioning

confidence: 89%

Recognition, Treatment and Complications of Meningococcal Disease

Riordan

Thomson

1999

Pediatric Drugs

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Meningococcal disease remains a major cause of death in young children. A decrease in mortality requires recognition and treatment of the disease at a number of stages in the illness. Life-threatening meningococcal disease usually presents as septicaemia rather than meningitis. The cardinal feature of meningococcal septicaemia is the purpuric rash. Many parents recognise the rash and seek medical advice because of it. When primary care physicians recognise the rash, the administration of parenteral penicillin may decrease mortality. However, antibacterials are not given promptly if there is no rash or if the disease presents in an atypical form. In hospital, antibacterial therapy with a third-generation cephalosporin should be given. Disease severity needs to be assessed by a valid method, such as the Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS). This can identify those patients who need intensive care and/or might benefit from new therapies. The 2 life-threatening complications are septic shock and meningoencephalitis with raised intracranial pressure. Despite numerous case reports of success with potential new treatments, none has been proven safe and/or effective by controlled trials. Although it is tempting to focus on new treatments, the early recognition of severe meningococcal disease by parents, primary care physicians and junior hospital doctors is equally, if not more, important as a potential means of decreasing mortality.

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“…Because of the scarcity of literature in this specific field, text and opinion literature including expert opinion, commentaries, reviews and narratives were also eligible for inclusion, as these constituted the best available evidence 17. The starting search date for papers was 1992, which was the year of publication of several of the seminal papers investigating the use of antibiotics for IMD in the community setting 18–22. There were no language restrictions on the search or screening processes; Google Translate was used to perform a translation of the title and abstract of any sources if they were located in the searches and appeared to possibly fit the inclusion criteria.…”

Section: Methodsmentioning

confidence: 99%

Care of the patient with invasive meningococcal disease by prehospital emergency medical service clinicians: a scoping review

et al. 2020

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ObjectiveThe objective of this scoping review is to systematically map the literature to identify the scope, depth, key concepts and gaps in the evidence regarding care of the patient with invasive meningococcal disease by emergency medical service (EMS) clinicians.DesignScoping review. This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guideline.Eligibility criteriaSources which focused on patients with invasive meningococcal disease (population), where the care of EMS clinicians was the focus (concept), in EMS systems worldwide (context) were eligible for inclusion.Search strategyThis review utilised a comprehensive search strategy including MEDLINE, Embase, Emcare, CINAHL, Scopus, Web of Science, Google Scholar and ‘grey’ literature databases from 1992 to January 2019. The search also included a Google search, a hand-search of relevant journals, screening of reference lists, contact with authors of included sources and use of social media in an attempt to locate all sources of evidence which fit the inclusion criteria of the review. Two reviewers independently screened sources for inclusion.ResultsThe search yielded 1803 unique records, of which 10 were included in the synthesis. No original research papers were identified, with all sources classed as either clinical audit or text and opinion literature. The dominant concept throughout the literature is that early antibiotic therapy is critical in the treatment of invasive meningococcal disease.ConclusionsOverall, there is a very narrow scope and shallow depth of literature on the topic of interest. There are gaps in the evidence regarding the care of the patient with invasive meningococcal disease by EMS clinicians. Despite these shortfalls, current consensus-based guidelines should direct clinical practice. Further research is planned to bridge the gaps in knowledge to support best practice.

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Early parenteral penicillin in meningococcal disease.

Abstract: Practices associated with continuation of breastfeeding beyond 10 days. Figures are numbers (percettages) ofmothers Breast fed for 6 10 days (n=27) Breast fed for >10 days (n 109)

Cited by 17 publications

References 12 publications

Lesson of the Week: Who spots the spots? Diagnosis and treatment of early meningococcal disease in children

Lesson of the Week: Who spots the spots? Diagnosis and treatment of early meningococcal disease in children

Recognition, Treatment and Complications of Meningococcal Disease

Care of the patient with invasive meningococcal disease by prehospital emergency medical service clinicians: a scoping review

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