Association of treatment for bacterial meningitis with the development of sequelae

SummaryBackgroundBacterial meningitis continues to be a serious, often disabling infectious disease. The aim of this study was to assess the possibility that treatment influences the development of sequelae in childhood bacterial meningitis.MethodsTwo thousand four hundred and seventy-seven patients aged 1 month to 14 years with acute bacterial meningitis over a 32-year period were enrolled in the study. Data were collected prospectively from the Meningitis Registry of a tertiary university teaching hospital in Athens, Greece. Treatment was evaluated through univariate and multivariate analysis with regard to sequelae: seizure disorder, severe hearing loss, ventriculitis, and hydrocephalus.ResultsAccording to the multinomial logistic regression analysis, there was evidence that penicillin, an all-time classic antibiotic, had a protective effect on the occurrence of ventriculitis (odds ratio (OR) 0.17, 95% confidence interval (CI) 0.05–0.60), while patients treated with chloramphenicol had an elevated risk of ventriculitis (OR 17.77 95% CI 4.36–72.41) and seizure disorder (OR 4.72, 95% CI 1.12–19.96). Cephalosporins were related to an increased risk of hydrocephalus (OR 5.24, 95% CI 1.05–26.29) and ventriculitis (OR 5.72, 95% CI 1.27–25.76). The use of trimethoprim/sulfamethoxazole increased the probability of seizure disorder (OR 3.26, 95% CI 1.08–9.84) and ventriculitis (OR 8.60, 95% CI 2.97–24.91). Hydrocortisone was associated with a rise in hydrocephalus (OR 5.44, 95% CI 1.23–23.45), while a protective effect of dexamethasone (OR 0.82, 95% CI 0.18–3.79) was not statistically significant.ConclusionsCurrent study findings suggest that the type of antimicrobial treatment for childhood bacterial meningitis may influence in either a positive or a negative way the development of neurological sequelae.