Abstract

DIAZ ALVAREZ, Manuel et al. Treatment without antibiotics in febrile infants presenting with cerebrospinal fluid pleocytosis and supposed viral meningitis. Rev Cubana Pediatr [online]. 2011, vol.83, n.1, pp.1-13. ISSN 0034-7531.

INTRODUCTION. The aim of present research was to present the antibiotic-therapy experience in febrile newborn (NB) presenting with cerebrospinal fluid pleocytosis (CSFP) and supposed viral meningitis. METHODS. A retrospective study was conducted in 310 NB diagnosed with aseptic meningitis admitted in the Neonatology Service of the "Juan Manuel Márquez" Children University Hospital between 1992 and 2009. Using the descriptive statistic method the indication or not of antibiotic treatment, moment and indication reasons were determined. RESULTS. There were 204 NB (65,8%) presenting with aseptic meningitis favorably discharged without antibiotic treatment. In 106 NB (34,2%) antibiotics were prescribed (in 76 immediately to be diagnosed with meningitis and in 30 cases, due to different reasons. The reasons for immediate treatment were mainly the results of cytochemical examination of CSF very similar to that of bacterial meningitis and backgrounds of a high or persistent fever. In mediate indication the main reason was the concurrence urinary tract infection. In patients that never were received antibiotic treatment, the hospital stay mean was of 4 days (inter-quartile interval 3-5 days), and for those that received treatment it was of 5 days (inter-quartile 3-7 days) (p < 0,0001). CONCLUSIONS. It is advisable to review the approach to use the antibiotic treatment in the case of a NB from the community when there is CSF pleocytosis and the supposed existence of viral meningitis provided that there are conditions of qualified and continuous professional surveillance and a laboratory with enough resources to support a treatment strategy with a rational use of the antibiotic therapy.

Keywords : Newborn; viral meningitis; aseptic meningitis; fever; antibiotic treatment; cerebrospinal fluid.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )