COMPARATIVE STUDY OF THE RESPONSE IN CHILDREN WITH MENINGOCOCCAL
MENINGITIS (MC) TO I.V. BENZYL PENICILLIN AND AQUEOUS CHLORAMPHENICAL (STD)
VERSUS LONG ACTING OILY CHLORAMPHENICAL (LAOC)
Shendi HMO, Hashim MSirK, Saed NS
Dept. of Pediatrics, Faculty of Medicine, University of Khartoum,
P. O. Box 102, Khartoum, Sudan
During 1999 a major
epidemic of (MC) disease took place in Sudan with a total of 33,437
patients affected, (CFR. of 7.4%). Age group affected mostly was children
5-14 years (41%), 15-19y (32%), 2-<5y (11%), 30-44y (8.5%), >4 years
(4.5%) and finally 0-2y (3%). In Khartoum State 3,292 were diagnosed with
287 deaths, (CFRate 8.7%); age group most affected was 15-29y (41.7%),
followed by 5-14y (28%). 128 children 0-15 years were included in a
descriptive and prospective study.
Objectives: Of these 128 children studied, 96 were
included in the drug comparison, 53 received the (STD) treatment, while 43
received the (LAOC) treatment. The objectives were to assess the immediate
outcome, response to the two different regimens and document the short-term
complications.
Methods: Information, history and detailed examinations
were recorded. Laboratory investigations include haematological, (CSF)
morphology and cytology, Gm stain, culture, sensitivity, Latex
Agglutination and serotyping were conducted. Group (A) patients were given
the (STD) while group (B) were given the (LAOC). Children < one year,
with meningococcaemia, partially treated (CSM), with complications and
those who received other antibiotics were excluded from the study.
Results: The results revealed no significant difference
in the response of the two groups (A) & (B) in regard to temperature,
level of consciousness, (CSF) Gm stain and culture and mortality rate; with
significant reduction in (CSF) sugar in both age groups, while response to
neck-stiffness and (CSF) turbidity was delayed in group (B) patients (LAOC)
group. Complications in this group were hearing impairment (3) and ataxia
(2) patients. Moreover the hospital stay was less than (<7) days in
(73.7%) of the patients of (LAOC) group, while it was (>7days) in all
patients of (STD) group.
Conclusion: Treatment with (LAOC) is effective and
significantly comparable, in response and immediate outcome to the (STD)
treatment. Moreover, the hospital stay is significantly shorter, with
consequent less cost and medical burden to the patient and hospital.
Certainly, we do recommend its use, and particularly in remote and rural
areas where facilities for I.V. therapy and monitoring are not available.