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Cited by 68Bacterial Infections and VaccinesAntibiotics Pharmacokinetics and EfficacyStreptococcal Infections and Treatments

Short versus long duration of antibiotic therapy for bacterial meningitis: a meta-analysis of randomised controlled trials in children

Karageorgopoulos, D E, Valkimadi, P E, Kapaskelis, A, Rafailidis, P I, Falagas, M E·2009·Archives of Disease in Childhood
DOI 10.1136/adc.2008.151563
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Abstract

OBJECTIVE: To evaluate the effectiveness and safety of short-course antibiotic therapy for bacterial meningitis, by performing a meta-analysis of randomised controlled trials (RCT). REVIEW METHODS: PubMed and the Cochrane Central Register of Controlled Trials were searched for RCT on patients of all ages with community-acquired acute bacterial meningitis that compared treatment with the same antibiotics, in the same daily dosage, administered for a short course (up to 7 days) versus a longer course (2 days or more than corresponding short course). RESULTS: Five open-label RCT involving children (3 weeks to 16 years) were included. No difference was demonstrated between short-course (4-7 days) and long-course (7-14 days) treatment (intravenous ceftriaxone) regarding: end-of-therapy clinical success (five RCT, 383 patients, fixed effect model (FEM), odds ratio (OR) 1.24, 95% CI 0.73 to 2.11); long-term neurological complications (five RCT, 367 patients, FEM, OR 0.60, 95% CI 0.29 to 1.27); long-term hearing impairment (four RCT, 241 patients, FEM, OR 0.59, 95% CI 0.28 to 1.23); total adverse events (two RCT, 122 patients, FEM, OR 1.29, 95% CI 0.57 to 2.91); or secondary nosocomial infections (two RCT, 139 patients, random effects model, OR 0.45, 95% CI 0.05 to 3.71). The duration of hospitalisation was lower with short-course treatment (two RCT, 137 patients, FEM, weighted mean difference -2.17 days, 95% CI -3.85 to -0.50). The available data did not allow for analysis by causative organism. CONCLUSION: This meta-analysis of the rather limited available relevant data could not show differences between short and long-course antibiotic treatment for bacterial meningitis in children. Further research on this issue is required.

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  • The duration of antibiotics in adults is based largely on expert opinion and is dependent on the organism isolated and clinical response.

    “Therefore, the duration of antibiotics in adults is based largely on expert opinion and is dependent on the organism isolated and clinical response (Table 3).”

    From Community-acquired acute bacterial meningitis in adults: a clinical update (2019) · cites this paper as [46]

  • A meta-analysis of all-cause ABM in children demonstrated non-inferiority between 4 and 7 and 7 and 14 days of treatment.

    “A metaanalysis of all-cause ABM in children demonstrated non-inferiority between 4 and 7 and 7 and 14 days of treatment.46”

    From Community-acquired acute bacterial meningitis in adults: a clinical update (2019) · cites this paper as [46]

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Authors
Karageorgopoulos, D. E., Valkimadi, P. E., Kapaskelis, A., Rafailidis, P. I., & Falagas, M. E.
Affiliations
  • Alfa Institute of Biomedical Sciences (GR)
  • Henry Dunant Hospital (GR)
  • Tufts University (US)
Corresponding author
Falagas, M E
ORCID
Venue
Archives of Disease in Childhood
Publisher
BMJ
Published
2009-07-23
Volume
94
Issue
8
Pages
607-614
ISSN
  • 0003-9888 (ISSN-L)
  • 1468-2044
DOI
10.1136/adc.2008.151563
OpenAlex
W2147804894
Cited by
68
References
40
Citations by year
2026: 2 · 2025: 4 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 7 · 2019: 6 · 2018: 2 · 2017: 4 · 2016: 4 · 2015: 4 · 2014: 3 · 2013: 5 · 2012: 4
FWCI
0.58
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Disease in Childhood (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
bacterial meningitis, antibiotic duration, short-course antibiotic therapy, ceftriaxone, children, neurological complications, hearing loss, adverse events, nosocomial infections, length of hospital stay, community-acquired meningitis
MeSH terms
Administration, Oral, Adolescent, Anti-Bacterial Agents, Ceftriaxone, Child, Child, Preschool, Cross Infection, Humans, Infant, Infant, Newborn, Randomized Controlled Trials as Topic, Meningitis, Bacterial, Hearing Loss

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