Impact of Antibiotic Pretreatment on Cerebrospinal Fluid Profiles
Rebecca Cook
Chadi M. El Saleeby
Effect of Antibiotic Pretreatment on Cerebrospinal Fluid Profiles of Children With Bacterial Meningitis
Nigrovic LE, Malley R, Macias CG, et al. Pediatrics. 2008;122(4):726–730
Background
Treatment with antibiotics before sampling cerebrospinal fluid (CSF) complicates the interpretation of CSF parameters including cell counts, chemistries, and cultures in children with bacterial meningitis. Prior data on the impact of antibiotic pretreatment were published before vaccines against Haemophilus influenzae type b and Streptococcus pneumoniae became widely available. This study sought to reassess the impact of antibiotics on CSF parameters in the conjugate vaccine era.
Objectives
To evaluate the effect of antibiotic pretreatment on the CSF profiles of children with bacterial meningitis.
Methods
Retrospective cohort study at 20 pediatric emergency departments (ED) from 2001 to 2004.
Patients
245 children ages 1 month to 18 years diagnosed with definite bacterial meningitis (positive CSF culture, or CSF pleocytosis ≥10 white blood cells [WBC]/μL with positive blood culture or CSF latex agglutination test) or probable bacterial meningitis (positive CSF Gram stain with negative blood or CSF cultures). Select exclusion criteria: CSF shunt, recent neurosurgery, or immunosuppression.
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