Meningitis: Ceftriaxone was safe and effective

Clinical bottom line (level 2c)

  1. A tenth of patients with bacterial meningitis who were given ceftriaxone died.
  2. A tenth of patients had neurological sequale, and a quarter had side effects to ceftriaxone.
Cabellos et al: Clinical Infectious Diseases 1995; 20: 1164-1168
Expires January 2003

The study

Outcome study with objective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: university hospital, Spain

84 patients (aged range 16 to 91 years; mean 42, 56% female) bacterial meningitis treated with ceftriaxone

Excluded if
  • <16 years old


    • Ceftriaxone 50 mg/kg iv once daily (to maximum dose 4 g, unless pneumococcal infection suspected, then given 100 mg/kg).

    100% followed for length of hospital stay
    Outcomes studied:
  • death
  • neurological sequale
  • side effects

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)    		 NNF
    (95% CI)
    death length of hospital stay 11/84 13%
    (5.9% to 20%)    		 8
    (5 to 17)
    neurological sequale length of hospital stay 8/84 9.5%
    (3.2% to 16%)    		 11
    (6 to 31)
    side effects length of hospital stay 19/84 23%
    (14% to 32%)    		 4
    (3 to 7)

    Comments

    1. No if ceftriaxone has been applied empirically, or as an adjusted treatment after the resistogram was obtained.
    2. Range of side effects recorded not noted

    Citation

    1. Cabellos C, Viladrich PF, Verdaguer R, et al: A single daily dose of ceftriaxone for bacterial meningitis in adults: experience with 84 patients and review of the literature. Clinical Infectious Diseases 1995; 20: 1164-1168
    Contributor: Bob Phillips and Clare Wotton, February 2000
    Reviewer: Dirk Stengel

    Clinical Question.
    Patient adults with bacterial meningitis
    Intervention or Exposure given ceftriaxone
    Outcome mortality; neurological sequale; adverse effects