Treatment of Neonatal Purulent Meningitis with a Sulphamethoxazole (SMZ)/Trimethoprim (TMP) Combination

  • Sumarmo Sumarmo Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Mugiyo Mugiyo Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Priutomo Priutomo Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Sofyan Ismael Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Muslim A. Nathin Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
DOI: https://doi.org/10.14238/pi22.7-8.1982.119-25
Keywords: neonatal purulent meningitis, sulphamethoxazole, trimethoprim, SMZ, TMP

Abstract

This paper describes our experience in treating neonatal meningitis with an intravenous Sulphametoxazole/Trimethoprim (SMZ-TMP) combination.


Fifteen neonates ranging in age from 6 to 36 days were included in this study. Cerebrospiral fluid isolates were as follows:

S. havana (3), S. oranienburg (2) and Haemolytic streptococci (1), the remaining 9 cultures were negative. Those bacteria isolated were all sensitive to SMZ/TMP. A solution of SMZ 80 mg/ml and TMP 16 mg/ml in 40% propylene glycol was used with a daily dose of 10 mgfkg B.W. TMP for the first 3 days followed by 6 mg/kg B.W. TMP for 18 days or longer, divided in two dose given intravenously every 12 hours.

Thirteen patients recovered, but two died of neurological complications, one with ventriculitis and the other with a subdural empyema.


No hematological or cutaneous or gastrointestinal side effects were observed. The liver and renal function tests performed on 5 out of the 15 patients on the first few days of hospitalization and 3 weeks later were all within normal lirnits. The use of parenteral SMZ-TMP in neonatal meningitis showed an encouraging result considering the fact rthat our previous mortality rate was 60%.

References

1. BAUER, C.H.; NEW, M.l.; MILLER, ) .M. : · Cerebrospinal fluid protein values of premature infants. J. Pediatr. 66 : 1017 (1965).
2. BERMAN, P.H.; BANKER, B.Q. : Neonatal meningitis. Pediatrics 38 : 6 (1966).
3. B0UDERLlQUE, C.; BROSSlER, J.P. Interet de Ia perfusion de
trimethoprime sulfamethoxazole dans les infection severes du nouveau-ne de !'enfant. Archives Medicates de L'Ouest 12 : 395 (1980).
4. CHEVRIE, J.J.; AICARDI, Y: : Bacterial mt ningitis among newborn infants. Clin Paediatr 8 : 562 (1969).
5. DYGGVE, H. : Prognosis in meningitis neonatorum. Acta Paediatr. Scand. 51 : 303 (1962) .
6. LEWIS, B.R;; GUPTA, J .M . . : Present prognosis in neonatal meningitis. Med J Aust 1 : 695 (1977).
7. LINDBERG, J.; ROSENHALL, U; NYLEN, 0 .. : RINGER, A. : Longterm
outcome of Hemophilus influenzae meningitis related to antibiotic treatment. -Pediatrics 60 : 1 (1977).
s: '' McCRACKEN, G.H: - : Neonatal septicemia and meningitis. Hospital Practice pp . 89-97, January ,,1976.
9. McCRACKEN, G.H. : Intraventricular treatment of neonatal meningitis due to gram-riegative bacilli. Editor's column. J. P.ediatr. 91 : 1037 (1977).
10. MONINTJA, H.E;; SUHARJONO; RACHMA F. BUDJANG; SRIWEN_IN9 R .. SAID!; HADI BUDIANTO : Cerebrospinal
fluid in normal newborns in Jakarta; Paediatr. Indones. 11 : 7 (1971).
11. MORIZARIA, R.N.; WALTON, I.G.; PICKERING, D. : Neonates meningitis trated with trimethoprim and sulphamethoxszole. Br. Med. J. II : 512 (1969).
12. ODELL, G.B. : The dissociation of bilirubin from albumin and its clinical implication. J. Pediatr. 55 : 268 (1959).
13. OVERTURF, G.D.; WEHRLE, P.F. Bacterial meningitis. Which regimen?
Medical Progress 6 : 72 (1979).
14. SABEL, K.G.; BRANDBERG, A. : Treatment of meningitis and septicemia in infancy with sulphamethoxazole-trimethoprim combination . Acta Pediatr. Scand 64 : 25 (1972).
15. SMITH, R.T.; PLATOU, E.S.; GOOD, R.A. : Septicemia of the newborn. Current status of the problem. Pediatrics 17 : 549 (1956).
16. WATSON, D.G. : Purulent neonatal meningitis, a study of forty five cases r. Pediatr. 50 : 352 (1957) .
Published
1982-08-30
How to Cite
1.
Sumarmo S, Mugiyo M, Priutomo P, Ismael S, Nathin M. Treatment of Neonatal Purulent Meningitis with a Sulphamethoxazole (SMZ)/Trimethoprim (TMP) Combination. PI [Internet]. 30Aug.1982 [cited 27Apr.2024];22(7-8):119-5. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1619
Issue
Vol 22 No 7-8 (1982): July - August 1982
Section
Infection & Tropical Pediatrics

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Received 2017-08-24
Accepted 2017-08-24
Published 1982-08-30