[An analysis of prior antibiotic treatment on the impact of meningococcal disease in children of the Valencian Community. The Study Group of Invasive Diseases].

OBJECTIVE

The objective of this study was to describe the effect of antibiotics given prior to hospitalization of children with meningococcal disease and to assess their relationship with disease outcome and microbiological isolation.

PATIENTS AND

METHODS

A prospective surveillance system in all hospitals of the Community of Valencia was implemented. All cases of children less than 15 years of age with clinically suspected invasive disease and: 1) N. meningitidis isolated in a normally sterile body fluid; 2) positive capsular antigens in blood or CSF and a positive Gram stain; and 3) clinical diagnosis of an invasive N. meningitidis disease.

RESULTS

In a two-year period 157 cases were reported. In 143 cases, data about antibiotic prescription prior to hospitalization was known. Of these, 24.5% had received antibiotics and none had received parenteral penicillin or cephalosporins. Oral antibiotics decreased bacterial isolation (p < 0.001) and did not modify outcome (p = 0.66).

CONCLUSIONS

Oral antibiotics, not recommended for N. meningitidis diseases, did not modify prognosis, but decreased bacterial isolation, and therefore worsened clinical handling of the cases and epidemiological studies.