PROSPECTIVE COMPARISON OF CEFTRIAXONE AND CEFOTAXIME FOR THE SHORT-TERM TREATMENT OF BACTERIAL-MENINGITIS IN CHILDREN

The effectiveness and safety of ceftriaxone and cefotaxime in the shor t-term treatment of primary bacterial meningitis were compared using a prospective, randomized, multicenter study design, Children between t he ages of 6 weeks and 16 years received either ceftriaxone as a singl e dose (100 mg/kg on the first day followed by 75 mg/kg/day) or cefota xime as four divided doses (200 mg/kg/day) for 4-7 days. A total of 82 patients (44 ceftriaxone, 38 cefotaxime) with documented bacteria in the CSF were studied. In patients receiving ceftriaxone, full recovery occurred in 79.5% while a further 13.7% recovered with neurologic seq uelae. Full recovery was observed in 71.1% of children treated with ce fotaxime with sequelae in a further 23.6% (no statistically significan t differences between drugs). The time to clinical improvement and res olution of fever (3-4 days) was also similar for both drugs. All but 1 of the 82 patients studied had negative CSF cultures within 24 h of t he beginning of therapy consistent with the excellent penetration into the CSF (trough concentrations of 2.7 mg/l for both drugs at the end of therapy). No differences were observed in the incidence of clinical ly significant adverse events. Ceftriaxone and cefotaxime are both eff ective in the treatment of bacterial meningitis. Ceftriaxone offers an advantage in ease of administration since it is administered as a sin gle daily dose.