Meningitis in children

In the treatment of bacterial meningitis in children, the drug of choice is... 

In the past, H. influenzae was the most common cause of meningitis in children 6 months to 3 years of age, but this has declined dramatically since the introduction of effective vaccines. 

It is used for bacterial infections caused by microorganisms that are sensitive to the drug. These may be abdominal and gynecological infections, sepsis, meningitis, endocarditis, infections of the urinary and respiratory tracts, bones, joints, skin, and soft tissnes. It is widely nsed for pneumonia as well as bacterial meningitis in children, and for post-operational infections complications. Synonyms of this drug are ceftin, zinacef, curoxim, kefox, and many others. 

Cryptococcal meningitis The recommended dosage is 12 mg/kg on the first day, followed by 6 mg/kg once daily. A dosage of 12 mg/kg once daily may be used. The recommended duration of treatment for initial therapy of cryptococcal meningitis is 10 to 12 weeks after the CSF becomes culture negative. For suppression of relapse of cryptococcal meningitis in children with AIDS, the recommended dose is 6 mg/kg once daily. 

The answer is e. (Hardman, pp 1094—1095.) Penicillins were used in the treatment of meningitis because of their ability to pass across an inflamed blood-brain barrier. The third-generation cephalosporin, ceftriaxone, is preferred because it is effective against P-lactamase producing strains of H. influenzae that may cause meningitis in children. 

Wong VK, Wright HT Jr, Ross LA, Mason WH, InderUed CB, Kim KS. Imipenem/cilastatin treatment of bacterial meningitis in children. Pediatr Infect Dis J 1991 10(2) 122-5. 

Schaad UB, Suter S, Gianella-Borradori A, Pfenninger J, Auckenthaler R, Bernath O, Cheseaux JJ, Wedgwood J. A comparison of ceftriaxone and cefuroxime for the treatment of bacterial meningitis in children. N Engl J Med 1990 322(3) 141-7. 

S. pneumoniae is the leading cause of meningitis in adults. Moreover, S. pneumoniae is the most common cause of bacterial meningitis in children younger than 2 years of age, accounting for 45 to 145 cases... 

Saez-Llorens X, McCracken Jr GH. Bacterial meningitis in children. Lancet 2003 361 2139-2148. 

Reefhuis J, Honein MA, Whitney CG, et al. Risk of bacterial meningitis in children with cochlear implants. N Engl J Med 2003 349 435 45. 

Girgis NI, Earid Z, Mikhail lA, et al. Dexamethasone treatment for bacterial meningitis in children and adults. Pediatr Infect Dis J 1989 8 848-851. 

Schaad UB, Lips U, Gnehm HE, et al. Dexamethasone therapy for bacterial meningitis in children. Swiss Meningitis Smdy Group. Lancet 1993 342 457 61. 

Waecker NJ. Tuberculosis meningitis in children. Curr Treat Options Neurol 2002 4 249-257. 

Arditi, M, Manogue, KR, Caplan, M and Yogev, R (1990) Cerebrospinal fluid cachectin/ tumor necrosis factor-a and platelet-activating factor concentrations and severity of bacterial meningitis in children. 7 7n/ecf DA, 162, 139-147. 

The battery of neuropsychological tests was designed to assess a range of functions implicated in previous studies of (a) chronic solvent abuse or occupational exposure to solvents, or (b) other CNS exposures, such as alcohol abuse in adults or severe head injury or meningitis in children and adolescents. It included measures of general intellectual and reading ability as well as tests to assess more specific functions such as psychomotor speed, attention, memory, manual and digital dexterity, and vibration perception. 

Ramachandran P, Duraipandian M, Nagarajan M, Prabhakar R, Ramakrishnan CV, Tripathy SP. Three chemotherapy studies of tuberculous meningitis in children. Tubercle 1986 67(l) 17-29. 

Levy C, Varon E, Taha MK, et al. Change in French bacterial meningitis in children resulting from vaccination. 

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