Therapy ofHaemophilus influenzaeMeningitis Reconsidered

Abstract

Ampicillin and chloramphenicol therapy for Haemophilus influenzae meningitis was compared, retrospectively. The 136 ampicillin recipients and 116 chloramphenicol-treated patients proved to be well matched in relation to age, duration of symptoms before treatment, and initial cerebrospinal-fluid findings. Fever was prolonged in a significant number (p less than 0.0025) and was of greater magnitude (p less than 0.0025) in ampicillin recipients. No significant differences were apparent in mortality or other infection-associated complications except for bacteriologic relapse, which occurred in six ampicillin recipients, some of whom received ampicillin intravenously in high dosage and for a prolonged time. Four additional ampicillin recipients had slow bacteriologic responses. Low cerebrospinal-fluid ampicillin concentration was documented in patients receiving ampicillin in a dose of 300 mg per kilogram per day intravenously. Low cerebrospinal-fluid glucose concentrations after therapy were frequently noted with both therapeutic regimens and did not signify persistent bacterial disease; other spinal-fluid findings were comparable.