Meropenem versus cefotaxime-based therapy for the initial treatment of infants and children hospitalised with non-CNS infections

Objective: This study compared the efficacy and tolerability of meropenem m onotherapy and cefotaxime-based therapy in infants and children hospitalise d with non-CNS infections. Patients: Children aged 2 months to 12 years were eligible for enrolment if they had signs and symptoms of respiratory tract infection, urinary tract infection, presumed septicaemia, skin/skin-structure infection or intra-abd ominal infection. Methods: A total of 505 patients from 21 centres throughout the USA were en rolled. Of these, 253 were randomised to meropenem treatment and 252 to cef otaxime-based treatment. In all, 205 and 178 patients in the meropenem- and cefotaxime-based treatment groups, respectively, were clinically evaluable . Patients received 2 to 15 days of therapy, and 70% received routine oral antibiotic therapy after parenteral therapy was discontinued. Results: Satisfactory results at the end of parenteral treatment were repor ted in 98% of meropenem-treated patients and 96% of those treated with cefo taxime-based therapy. These response rates were sustained at follow-up, irr espective of the use of additional antibiotic therapy. Meropenem was genera lly well tolerated. Overall, adverse events occurred with similar frequency in both treatment arms. No seizures or deaths were reported in either trea tment group. Conclusion: Meropenem was well tolerated and effective for the initial empi rical treatment of children hospitalised with non-CNS infections.