Once-daily administration of ceftriaxone in the treatment of meningitis and other serious infections in children.

Forty-three children (ten neonates, 15 infants and 18 older children) were treated with single daily doses of ceftriaxone (50 to 100 mg/kg) intravenously or intramuscularly for serious bacterial infections. The infections included meningitis (31 patients), brain abscesses (four patients), septicaemia (three patients), pleuro-pneumonia (two patients), septic arthritis and soft tissue phlegmona (three patients). No other antibacterial agents were used except in four patients with brain abscesses, in whom ceftriaxone was combined with ornidazole. The overall bacteriological cure rate was 98%, and sterilisation of the cerebrospinal fluid occurred in 27 of 28 patients (96%) with proven bacterial meningitis. Two patients died, three survived with severe neurological sequelae; one neonate required partial gut resection. A complete clinical cure was achieved in the remaining 37 patients. Only one treatment failure was directly related to the drug therapy. The only side effect noted were sterilisation of the gut with overgrowth of Candida albicans in 35% of neonates and infants, an prolonged fever in 13% of all patients. Ceftriaxone given in a 24-hourly regimen is convenient and highly effective in serious bacterial infections in children and is without significant toxicity.