Cefuroxime Treatment Failure and Haemophilus influenzae Meningitis: Case Report and Review of Literature

Abstract

Bacterial meningitis continues to be a major cause of morbidity and mortality in children despite effective antimicrobial therapy. Ampicillin and chloramphenicol have been the treatments of choice for bacterial meningitis in children older than 3 months of age, but recommendations also include cefuroxime and third-generation cephalosporins as possible single-drug alternatives. Although cefuroxime has been reported to be as effective as conventional therapy and some have recommended it for treatment of bacterial meningitis in children, there have been recent concerns about its efficacy. The purpose of this report is to describe an infant who had a relapse of Haemophilus influenzae meningitis 1 day after completing 30 days of therapy with iv cefuroxime for H influenzae meningitis complicated by sterile subdural effusion and possible osteomyelitis.