Cited by 265Bacterial Infections and VaccinesBacterial Identification and Susceptibility TestingStreptococcal Infections and Treatments

The DOI matches its Crossref record, with a small difference in title or year; 39 of the 40 references it cites were found in a registry or an index.

Early treatment with parenteral penicillin in meningococcal disease.

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Abstract

OBJECTIVE: To measure the effect of parenteral antibiotics given before admission to hospital on mortality and on bacteriological investigations in meningococcal disease. DESIGN: Retrospective review of hospital notes and laboratory and public health medicine department records. SETTING: Three health districts in south west England. SUBJECTS: Patients with meningococcal disease in Gloucester district presenting between 1 January 1982 and 31 December 1991 (n = 190); patients with meningococcal disease in Plymouth (n = 118) and Bath (n = 73) districts presenting between 1 January 1988 and 31 December 1991 (total = 381). MAIN OUTCOME MEASURE: Number of deaths from meningococcal disease. RESULTS: Parenteral antibiotic given by general practitioners was associated with a substantial reduction in mortality (from 9% to 5%; relative risk 0.6, 95% confidence interval 0.2 to 1.5); patients with a rash were more likely to be given parenteral antibiotics, and mortality was further reduced (from 12% to 5%; 0.5, 0.2 to 1.4). In a district where such treatment was regularly encouraged its use increased from 5% to 40% of cases over 10 years (p = 0.00001). Treatment with parenteral antibiotics before admission made isolation of meningococci from blood and cerebrospinal fluid less likely but did not affect nasopharyngeal cultures. CONCLUSIONS: General practitioners should carry benzylpenicillin in their emergency bags at all times and should administer it promptly, preferably intravenously, whenever meningococcal disease is suspected, unless the patient has had an anaphylactic reaction to penicillin. Specimens for culture should include a nasopharyngeal swab.

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Crossref · 10.1136/bmj.305.6846.143

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Show all 40 references

Research works printed but not linked: 4

  1. Harvey IM, Palmer SR, Peters TJ. Meningitis: can we trust the statistics? Health Trends 1989;21:73-6.
  2. Hyg (Camb) 1984;93:167-80.
  3. Banks HS. Meningococosis. A protean disease. Lancet 1948;ii:635-40, 677-81.
  4. Department of Health and Social Security. Meningococcal infection: meningitis and septicaemia. London: DHSS, 1988. (PL/CMO(88)2.) 19 Drugs for the doctor's bag 1989. Drug Ther Bull 1989;27:17-9.

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Metadata

Authors
Cartwright, K., Reilly, S., White, D., & Stuart, J.
Affiliations
Gloucestershire Royal Hospital (GB)
Venue
BMJ
Publisher
BMJ
Published
1992-07-18
Volume
305
Issue
6846
Pages
143-147
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
OpenAlex
W2049273725
Cited by
265
References
40
Citations by year
2026: 1 · 2025: 1 · 2023: 2 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 6 · 2015: 2 · 2014: 5 · 2013: 2 · 2012: 5
FWCI
9.12
Type
journal article
Language
en
Open access
Locations
  • BMJ (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Medicine › Microbiology (medical) › Bacterial Identification and Susceptibility Testing
  • Health Sciences › Medicine › Infectious Diseases › Streptococcal Infections and Treatments
Keywords
meningococcal disease, penicillin G, mortality, general practitioners, nasopharyngeal culture, cerebrospinal fluid culture, rash
MeSH terms
Humans, Infusions, Parenteral, Meningitis, Meningococcal, Meningococcal Infections, Nasopharynx, Neisseria meningitidis, Patient Admission, Penicillin G, Prognosis, Time Factors, Treatment Outcome, Sepsis

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