An extended experience with cefuroxime therapy of childhood bacterial meningitis.

Eighty-four pediatric patients with bacterial meningitis were prospectively evaluated while receiving cefuroxime (200 mg/kg/day in four equal intravenous doses) as single-drug therapy for 9 to 13 days. Six cases were admitted in extremis and died within a few hours because of irreversible central nervous system damage or shock. The remaining 78 patients were cured, and prompt bacteriological and clinical responses were noted. The pathogens were Haemophilus influenzae b (43 cases), Neisseria meningitidis (20 cases), Streptococcus pneumoniae (10 cases) and unknown (five cases). All pathogens were susceptible in vitro to cefuroxime including two strains of beta-lactamase producing H. influenzae. Time to defervescence, incidence and cause of both prolonged and secondary fever, as well as type and frequency of complications and sequelae compared favorably to other series. It is concluded that cefuroxime is effective and safe single-drug therapy for childhood bacterial meningitis beyond the neonatal age group.