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Intravenous Chloramphenicol plus Penicillin versus Intramuscular Ceftriaxone for the Treatment of Pyogenic Meningitis in Nepalese Children

Intravenous chloramphenicol plus penicillin versus intramuscular ceftriaxone for the treatment of pyogenic meningitis in Nepalese children A comparative study was done at 150-bed Kanti Children’s Hospital in Kathmandu to assess the efficacy of intravenous (i.v.) chloramphenicol plus penicillin versus intramuscular (i.m.) ceftriaxone for the treatment of pyogenic meningitis. Children aged 5 months to 5 years admitted on Sundays and Wednesdays to the Hospital for a period of 6 months (November 1993 to April 1994) with the diagnosis of pyogenic meningitis were included in the study. Patients who had already been given antibiotics prior to admission were not included in the study. The diagnosis was based on clinical features (fever of acute onset, vomiting, convulsion, and bulging fontanelle in infants) and the examination of cerebrospinal fluid (CSF). The CSF was subjected to cell count and latex agglutination test. Only those patients having a total CSF cell count of more than 100 with more than 60% polymorphs were included in the study. Patients were randomized to receive either i.v. chloramphenicol + benzyl penicillin every 6 h for 14 days