2000
DOI: 10.1159/000014208
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Treatment of Gram-Negative Bacterial Meningitis in Term Neonates with Third Generation Cephalosporins plus Amikacin

Abstract: The aim of this retrospective study was to evaluate the clinical efficacy in terms of mortality and long-term morbidity of third generation cephalosporins and amikacin in combination for the treatment of gram-negative bacterial meningitis in a homogeneous group of neonates. A 15-year experience (1983–1997) with 72 term neonates without central nervous system anomalies and with gram-negative organisms grown in their cerebrospinal fluid treated with the above combination of antibiotics is presented. All isolated… Show more

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Cited by 24 publications
(25 citation statements)
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“…It is likely that the presence of bacteria or their products in the CSF is related to the maintenance of the infl ammatory cascade and central nervous system injury. Fifty per cent of the deaths occurred in neonates with a positive culture for enterobacteria, which is supported by other studies that show a variation in mortality according to the type of microorganism isolated from the CSF, with enterobacteria being the most virulent 15,16 . Krebs et al 8 observed signifi cantly higher levels of IL-6 in the CSF of neonates with meningitis due to gram-negative bacteria, suggesting a higher intensity of the infl ammatory process in these newborns.…”
Section: Discussionsupporting
confidence: 77%
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“…It is likely that the presence of bacteria or their products in the CSF is related to the maintenance of the infl ammatory cascade and central nervous system injury. Fifty per cent of the deaths occurred in neonates with a positive culture for enterobacteria, which is supported by other studies that show a variation in mortality according to the type of microorganism isolated from the CSF, with enterobacteria being the most virulent 15,16 . Krebs et al 8 observed signifi cantly higher levels of IL-6 in the CSF of neonates with meningitis due to gram-negative bacteria, suggesting a higher intensity of the infl ammatory process in these newborns.…”
Section: Discussionsupporting
confidence: 77%
“…Treatment of meningitis in the neonatal period is longer than therapy provided to all the other age groups because of the high severity of the disease in the newborn and the elevated risk of recurrence, which might affect 7 to 21% of the cases, even after a full treatment course 15,16 . The authors recommend that the antibiotic therapy is maintained for at least 14 to 21 days after CSF culture becomes negative 12,16 . Additionally, we recommend the systematic CSF analysis before treatment withdrawal.…”
Section: Discussionmentioning
confidence: 99%
“…1 Ventriculoperitoneal or ventriculoatrial cerebrospinal spinal fluid (CSF) shunts are used to control the condition; however, they can become colonized with a variety of microorganisms that generally enter the shunt system during surgical placement. Although the most common organisms are coagulase-negative staphylococci (e.g., 40-56%) [1][2][3][4] and Staphylococcus aureus (e.g., 25%), the incidence of gram-negative bacillary (GNB) colonization has increased significantly over the last 30 years and is associated with fatality rates of 40-58%. [3][4][5] Those who survive GNB ventriculitis have a high incidence of neurological, psychological and/or developmental abnormalities.…”
Section: Introductionmentioning
confidence: 99%
“…Although the most common organisms are coagulase-negative staphylococci (e.g., 40-56%) [1][2][3][4] and Staphylococcus aureus (e.g., 25%), the incidence of gram-negative bacillary (GNB) colonization has increased significantly over the last 30 years and is associated with fatality rates of 40-58%. [3][4][5] Those who survive GNB ventriculitis have a high incidence of neurological, psychological and/or developmental abnormalities. 3,[5][6][7][8] A standardized therapeutic approach for the treatment of GNB ventriculitis has not been universally accepted.…”
Section: Introductionmentioning
confidence: 99%
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