PEDIATRICS Vol. 48 No. 3 September 1971, pp. 411-416
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A COMPARISON OF AMPICILLIN AND CHLORAMPHENICOL THERAPY IN HEMOPHILUS INFLUENZAE MENINGITIS

Martin L. Schulkind M.D.1, William A. Altemeier III M.D.1, and Elia M. Ayoub M.D.1

1 Department of Pediatrics, Division of Immunology and Infectious Disease, University of Florida College of Medicine, Gainesville, Florida

A comparison was made of the clinical courses of 37 patients treated for H. influenzae meningitis with either ampicillin or chloramphenicol. The only significant difference noted in the courses of the two groups of patients was a prolonged duration of fever in the ampicillin-treated patients. The prolonged febrile course was not accompanied by any evidence that the antibiotic had failed to eradicate the infection. Neither could the fever be explained on the basis of subdural effusion, intercurrent infections, phlebitis, or drug fever.

In all other respects, the H. influenzae meningitis patients treated with either ampicillin or chloramphenicol had similar responses to therapy. The mortality rate and the incidence of neurological sequelae were the same for both groups of patients.

These findings indicate that a prolonged febrile course may be expected during the effective treatment of H. influenzae meningitis with ampicillin. This persistent fever is, in itself, no indication for the replacement of ampicillin therapy as long as other criteria show evidence of a favorable response to therapy.

Submitted on February 26, 1971
Accepted on April 12, 1971