CoChat
Sign Up
Cited by 11Bacterial Infections and VaccinesAntibiotics Pharmacokinetics and EfficacyStreptococcal Infections and Treatments

Role of Rifampin in Reducing Inflammation and Neuronal Damage in Childhood Bacterial Meningitis: A Pilot Randomized Controlled Trial

Uppal, Lipi, Singhi, Sunit, Singhi, Pratibha, Aggarwal, Ritu·2017·Pediatric Infectious Disease Journal
DOI 10.1097/inf.0000000000001513
Open this paper in CoChat — free account

Abstract

BACKGROUND: Treatment of acute bacterial meningitis in children with bactericidal antibiotics causes cell wall lysis and a surge in inflammatory cascade, which in turn contributes to neuronal damage and morbidity. Pretreatment with a nonbacteriolytic antibiotic, such as rifampin, has been shown to attenuate the inflammatory response in experimental models of bacterial meningitis. In a pilot study, in children with bacterial meningitis, we have studied markers of inflammatory response and neuronal damage in 2 groups of children with bacterial meningitis; one group received rifampin pretreatment with ceftriaxone and the other group received ceftriaxone alone. PATIENTS AND METHODS: Forty children with bacterial meningitis, who were 3 months to 12 years of age, were randomly assigned to receive either a single dose rifampin (20 mg/kg) 30 minutes before ceftriaxone or ceftriaxone alone was given. The primary outcome variables were cerebrospinal fluid (CSF) concentrations of tumor necrosis factor alpha (TNFα), S100B and neuron-specific enolase on day 1 and day 5, and secondary outcome variables were the values of TNFα and interleukin 6 in serum on day 1 and day 5; hearing and neurologic sequelae at 3 months after recovery from the illness. RESULTS: Children in rifampin pretreatment group had significantly lower CSF TNFα concentrations [median (interquartile range [IQR]): 15.5 (7.2-22.0) vs. 53.0 (9.0-87.5) pg/mL, P = 0.019] and S100B [median (IQR): 145.0 (54.7-450.0) vs. 447.5 (221.0-804.6) pg/mL, P = 0.033] on day 1 and S100B [median (IQR): 109.7 (64.0-287.0) vs. 322 (106.7-578.0) pg/mL, P = 0.048] and neuron-specific enolase [median (IQR): 8.6 (5-14.75) vs. 18.2 (7.0-28.75) ng/mL, P = 0.035] on day 5 when compared with ceftriaxone alone group. The rifampin-treated group also had reduced morbidity and neurologic sequelae; however, these were not statistically significant. CONCLUSIONS: Pretreatment with single dose rifampin 30 minutes before ceftriaxone administration reduced the CSF concentrations of markers of inflammation and neuronal damage in children with bacterial meningitis.

Integrity signals

Registry

Crossref · 10.1097/inf.0000000000001513

Cites

16 of 16 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In animal models, doxycycline given as an adjunct alongside ceftriaxone downregulates CSF inflammation, leading to reduced mortality and attenuated hearing loss.

    “in animal models, when given as an adjunct alongside ceftriaxone, has been shown to downregulate CSF inflammation leading to reduced mortality and attenuated hearing loss.54”

    From Community-acquired acute bacterial meningitis in adults: a clinical update (2019) · cites this paper as [54]

Cites

Flagged first, then by citations

1 of the 17 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Uppal, L., Singhi, S., Singhi, P., & Aggarwal, R.
Affiliations
Post Graduate Institute of Medical Education and Research (IN)
Corresponding author
  • Uppal, Lipi
  • Singhi, Sunit
  • Singhi, Pratibha
ORCID
Venue
Pediatric Infectious Disease Journal
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2017-06
Volume
36
Issue
6
Pages
556-559
ISSN
0891-3668 (ISSN-L)
DOI
10.1097/inf.0000000000001513
OpenAlex
W2561814701
Cited by
11
References
17
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2019: 5 · 2018: 2
FWCI
2.38
Type
journal article
Language
en
Open access
closed
Locations
  • The Pediatric Infectious Disease Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Medicine › Pharmacology › Antibiotics Pharmacokinetics and Efficacy
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
Keywords
rifampicin, bacterial meningitis, pediatric meningitis, ceftriaxone, neuroinflammation, neuronal injury, TNF-α, S100B, neuron-specific enolase, interleukin-6, hearing loss, neurological sequelae, cell wall lysis, neuroprotection, cerebrospinal fluid
MeSH terms
Anti-Bacterial Agents, Ceftriaxone, Child, Child, Preschool, Cranial Nerve Diseases, Humans, Infant, Inflammation, Phosphopyruvate Hydratase, Pilot Projects, Rifampin, Tumor Necrosis Factor-alpha, Interleukin-6, Treatment Outcome, Meningitis, Bacterial, S100 Calcium Binding Protein beta Subunit

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review