Meningitis Occurring During Therapy for Otitis Media With Cephalexin and Cefaclor FREE

HAROLD S. RAUCHER, MD; RAMON J. C. MURPHY, MD; ASHER BARZILAI, MD

Am J Dis Child. 1982;136(8):745-746. doi:10.1001/archpedi.1982.03970440089029.

Text Size: A A A

Published online

Article

References

Comments

ABSTRACT

ABSTRACT | REFERENCES

Oral preparations of cephalosporins are often prescribed for the treatment of otitis media in children. These drugs are usually recommended after failure of therapy with other antibiotics.¹ However, many practitioners began treatment of otitis with cefaclor (Ceclor) or cephalexin monohydrate (Keflex). Both cephalexin and cefaclor have a pleasant taste and are effective against common middle ear pathogens including most strains of Haemophilus influenzae and Staphylococcus aureus. Cefaclor is more effective than ampicillin against β-lactamase-producing H influenzae strains.

An objection to the use of oral cephalosporins in infants and young children is their poor penetration of the blood-brain barrier, resulting in a low drug concentration in the CSF. We report a case of pneumococcal meningitis in a child who was receiving cefaclor and a case of H influenzae meningitis in a child who was receiving cephalexin therapy.

Report of Cases.—Case 1.—A 6-month-old boy was brought to his pediatrician

REFERENCES

ABSTRACT | REFERENCES

Ginsburg CM, McCracken GH Jr: Cefaclor and cefadroxil: A commentary on their properties and possible indications for use in pediatrics . J Pediatr 1980;;96:340-342.

Anhalt JP, Sabath LD, Barry AL: Special tests: Bactericidal activity, activity of antimicrobics in combination, and detection of beta-lactamase production , in Lennette EH, Balows A, Hausler WJ Jr, et al (eds): Manual of Clinical Microbiology , ed 3. Washington, DC, American Society for Microbiology, 1980;, pp 478-481.

Vianna NJ, Kaye D: Penetration of cephalothin into the spinal fluid . Am J Med Sci 1967;;254:216-220.

Lerner PI: Penetration of cephaloridine into cerebrospinal fluid . Am J Med Sci 1971;;262:321-326.

Bassaris HP, Quintiliani R, Maderazo EG, et al: Pharmacokinetics and penetration characteristics of cefazolin into human spinal fluid . Curr Ther Res 1976;;19:110-120.

Fisher LS, Chow AW, Yoshikawa TT, et al: Cephalothin and cephaloridine therapy for bacterial meningitis: An evaluation . Ann Intern Med 1975;;82:689-693.

Walker SH, Collins CC: Failure of cephaloridine in Haemophilus influenzae meningitis . Am J Dis Child 1968;;116:285-291.

Mangi RJ, Kundargi RS, Quintiliani R, et al: Development of meningitis during cephalothin therapy . Ann Intern Med 1973;;78:347-351.

Lorber B, Santoro J, Swenson RM: Listeria meningitis during cefazolin therapy . Ann Intern Med 1975;;82:226.

Steinberg EA, Overturf GD, Wilkins J, et al: Failure of cefamandole in treatment of meningitis due to Haemophilus influenzae type b . J Infect Dis 1978;;137:S180-186.

Chartrand SA, Marks MI, Roberts R, et al: Development of Haemophilus influenzae meningitis in patients treated with cefamandole . J Pediatr 1981;;98:1003-1005.

Bratton L, Teele DW, Klein JO: Outcome of unsuspected pneumococcemia in children not initially admitted to the hospital . J Pediatr 1977;;90:703-706.

Marshall RE, Teele DW, Klein JO: Unsuspected bacteremia due to Haemophilus influenzae: Outcome in children not initially admitted to hospital . J Pediatr 1979;;95:690-695.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal