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.
Statistics from Altmetric.com
Competing interests: None.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.