Treatment of Neonatal Purulent Meningitis with a Sulphamethoxazole (SMZ)/Trimethoprim (TMP) Combination
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%.
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Accepted 2017-08-24
Published 1982-08-30