A CROSS-SECTIONAL INVESTIGATION OF A CONTROLLED TRIAL OF INTRATHECAL ANTIBIOTIC THERAPY IN INFANTS WITH GRAM-NEGATIVE ENTERIC MENINGITIS
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Keywords
Gram Negative Bacteria, Intrathecal, Meningitis, Antibiotics
Abstract
Background: Gram-negative enteric meningitis in infants is a excessive and lifestyles-threatening situation because of bacteria which include Escherichia coli, Klebsiella species, and different enteric pathogens. This type of meningitis is specifically hard to treat due to the increasing occurrence of antibiotic-resistant strains and the difficulties in achieving therapeutic concentrations of antibiotics within the cerebrospinal fluid (CSF) due to the blood-mind barrier.
Objective: To assess the effectiveness and safety of the antibiotics administered intrathecally in infants suffering from gram negative enteric meningitis.
Methodology: The study included 100 infants diagnosed with Gram-negative enteric meningitis. The study was conducted at Naseer Teaching Hospital during the period from September 2022 to September 2023. They were then equally divided into two groups i-e intrathecal therapy group and systemic therapy group with 50 participants in each group. Their baseline characteristics including age, sex, birth weight, gestational age, and initial CSF WBC count were recorded. Bacterial degradation was observed at 46 hours, 7 days, and 10 days of treatment.
Results: The intrathecal group showed significantly higher bacterial clearance rates at 46 hours (p=0.04), 7 days (p=0.02), and 10 days (p=0.02). Peak CSF antibody concentrations were raised in the intrathecal therapy (p = 0.01), and serum concentrations were also higher (p = 0.03). Better outcomes were observed in the intrathecal group (p=0.03), with shorter hospital stay (p=0.001).
Conclusion: The use of intrathecal antibiotic is an advanced alternative to standard systemic antibiotic therapy for the control of gram-negative enteric meningitis in infants. The superior bacterial clearance, higher CSF antibiotic concentrations, and improved scientific results highlight it as an effective treatment modality.
References
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Dr Shafiq Ahmad
Lecturer, Department of Pharmacology, KMU Institute of Dental Sciences, Kohat
Dr Mehak E Fatima
Scholar MPhil Microbiology, Khyber Medical University (KMU), Peshawar (IPDM)
Dr Ronaq Zaman
Associate Professor, Department of Pathology, Kabir Medical College, Peshawar
Dr Amna Khalid
Lecturer, Department of Pathology, Jinnah Medical College, Peshawar
Dr Amjad Mustafa
Associate Professor Department of Pharmacology, KMU IMS, Kohat
Dr Sadaf Nasir
Assisstant Professor Microbiology, Department of Pathology, Rawal Institute of Health Sciences, Islamabad