Ceftriaxone Therapy of Bacterial Meningitis in Children

Main Article Content

Sumarmo Sumarmo
S. R. Harun
M. A. Nathin


Twenty-nine children, age 3 months to 11 years, admitted with the clinical diagnosis of bacterial meningitis to the Department of Child Health, were included in a prospective treatment study of ceftriaxone (RocephinHoffmann- La Roche AG Bas/e, Switzerland). Ceftriaxone was used as the only antibiotic agent in single daily dose of 100 mg/kg body weight given intravenously for a minimum of 10 days. Of these 29 patients, 25 (86.2%) recovered, 3 (10.3%) died and 1 (3.4%) no respond to treatment. Among fatal cases, two patients had subdural empyema and one had a cerebral abscess. The microorganisms isolated from cerebrospinal fluid were: Streptococcus pneumoniae (5), Pseudomonas sp. (4), Proteus sp. (2), Salmonella typhi (1), Escherichia coli (1), Clostridium sp. (1), Pseudomonas aeruginosa (1), Staphylococcus aureus {1), and Streptococcus haemolyticus (1). In 12 patients (41,4%), organisms were not identified. The diagnosis was made based on clinical symptoms, Gram staining, cell count. ~!┬Ětease, and protein in the CSF. In all patients, repeated spinal fluid cultures had no bacterial growth at 24 hours after initation of intravenous therapy. No evidence of clinical important drug toxicity was observed. Three p'Oiients, however, had lightly elevated hepatic transaminase levels, and one patient had rnild neutropenia. These clinical and bacteriological results suggested that ceftriaxone is reasonably safe and effective in the treatment of bacterial meningitis caused by the most common pediatric pathogens in Indonesian children over one month of age.

Article Details

How to Cite
Sumarmo S, Harun S, Nathin M. Ceftriaxone Therapy of Bacterial Meningitis in Children. PI [Internet]. 26Jul.2019 [cited 27Sep.2020];28(7-8):141-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2249
Pediatric Neurology
Received 2019-07-26
Published 2019-07-26


1. CONGENI, B.L.; BRADLEY, J .; HAMMERRSCHLAG, M.R.: Safety and efficacy of once daily ceftriaxone for the treatment of bacterial meningitis . Pediat. Infect. Dis. 5 : 293 (1986) .
2. DEL RIO, M.A. ; SHELTON, S.; CHRAHNE D.; Me CRACKEN Jr.G.H.; NELSON, J.D.: Ceftriaxone versus ampicillin and chloramphenicol for treatment of bacterial meningitis in children . Lancet i : 1241 (1983).
3. HAVLIK, J .; DUNIEWICSZ, M.; STANKOVA, M.; MARESOVA, V.: Ceftriaxone in the treatment of severe infections in childhood, especially bacterial meningitis. In: Rocephin: World wide literature review 1982-1984. P.T. Roche Indonesia Medical Information Service, Jakarta, p . 142- 143 (1987) .
4. LOLEKHA, S.; BOONRUMLUCKTANOM, S.; CHAROENPIPOP, D.: In vitro activity of ceftriaxone. In: Proceedings: progress in therapy of bacterial infect ions. A new cephalosporin: ceftriaxon"e. Excerpta Med. Asia Pasific Congr. Ser., No. 19, p . 38 (1983),
5. STOECKEL, K.; Me NAMARA, P.J .; BRANDT, R.; PLOZZA-NOTTEBROCK, H.; ZIEGLER, W .H.: Effects of concentration-dependent plasma protein bi"nding on ceftriaxone kinetics. Clin. Pharmacal. Ther. 29 : 650 (1981) .
6. STOECKEL, K.!Selected aspects of ceftriaxone kinetics . Excerpta Med. Asia Pasific Congr. Ser., No. 49, pp. I - 10 (1986).
7. SUMARMO; MUSLIM A. NATHIN; SOFY AN ' ISMAEL; TUMBELAKA, W.A.F.J .: Salmonella meningitis in the newborns and young infants in Jakarta, Indonesia. Paediatr. Indones. 22 : 198 (1982).