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document
Comparative trial of carbenicillin and ampicillin therapy for purulent meningitis . A randomized therapeutic trial of carbenicillin ( CB ) or ampicillin ( AMP ) in purulent meningitis was performed in 86 pediatric and adult patients ( 41 Haemophilus influenzae , 22 Streptococcus pneumoniae , 13 Neisseria meningitidis , and 10 of unknown etiology ) . All isolates , incuding H. influenzae , were susceptible to CB and AMP . Median cerebrospinal fluid ( CSF ) antibiotic concentrations were 0.85 and 1.60 mug/ml for CB and AMP , respectively , during administration of daily doses of 400 mg/kg and 0.65 and 0.45 mug/ml , respectively , on daily doses of 200 mg/kg . Higher CSF concentrations , up to a median concentration of 4.5 mug/ml , were observed in patients with CSF protein concentrations > /=75 mg/100 ml . Clinical responses were equivalent on either antibiotic regimen . Among AMP patients ( 45 ) , 8 had significant residua and 3 died ; among CB patients ( 41 ) , 5 had residua and none died . However , 38 % of H. influenzae patients treated with CB had positive CSF cultures on day 1 follow-up lumbar punctures , compared with only 5.8 % of AMP patients with H. influenzae . The significance of a delay of CSF sterilization among CB-treated patients is unknown , since there was no correlation between persistence of hemophilus organisms and the frequency of adverse outcome . AMP and CB are equivalent for the treatment of bacterial meningitis due to susceptible organisms .
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Intervention_Pharmacological
carbenicillin
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Intervention_Pharmacological
ampicillin
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Intervention_Pharmacological
carbenicillin ( CB ) or ampicillin ( AMP )
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Intervention_Pharmacological
AMP
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Intervention_Pharmacological
CB
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Intervention_Pharmacological
CB
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Intervention_Pharmacological
AMP
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Intervention_Pharmacological
CB
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Outcome_Physical
cerebrospinal fluid ( CSF ) antibiotic concentrations
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Outcome_Physical
Higher CSF concentrations
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Outcome_Physical
Clinical responses
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Outcome_Adverse-effects
had significant residua
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Outcome_Mortality
died ;
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Outcome_Physical
positive CSF cultures
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Outcome_Physical
delay of CSF sterilization
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Participant_Condition
purulent meningitis
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Participant_Sample-size
86
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Participant_Age
pediatric
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Participant_Age
adult
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Participant_Sample-size
41 Haemophilus influenzae
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Participant_Sample-size
22 Streptococcus pneumoniae
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Participant_Sample-size
13 Neisseria meningitidis
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Participant_Sample-size
10
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Participant_Condition
influenzae
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Participant_Condition
influenzae