Mortality indicators in pneumococcal meningitis: therapeutic implications.

摘要: Summary Background The aim of this study was to delineate mortality indicators in pneumococcal meningitis with special emphasis on therapeutic implications. Methods This retrospective, multicenter cohort involved a 15-year period (1998–2012). Culture-positive cases ( n =306) were included solely from 38 centers. Results Fifty-eight patients received ceftriaxone plus vancomycin empirically. rest given third-generation cephalosporin alone. Overall, 246 (79.1%) isolates found be penicillin-susceptible, (12.2%) strains penicillin-resistant, and 22 (7.1%) oxacillin-resistant (without further minimum inhibitory concentration testing for penicillin). Being critical case (odds ratio (OR) 7.089, 95% confidence interval (CI) 3.230–15.557) age over 50 years (OR 3.908, CI 1.820–8.390) independent predictors mortality, while infection penicillin-susceptible isolate 0.441, 0.195–0.996) protective. Empirical use did not provide significant benefit 2.159, 0.949–4.912). Conclusions Ceftriaxone alone is adequate the management due penicillin-resistant pneumococci, which major concern worldwide. Although showed trend towards improving prognosis meningitis, correlation statistical terms could established study. Thus, studies are needed optimization treatment.