Table 3.
Clinical outcomes, mortality, and sequalae of the three cohorts
| Outcome | cefepime + vancomycin (Total = 20) n/(%) |
ceftazidime + vancomycin (Total = 31) n/(%) |
meropenem + vancomycin (Total = 119) n/(%) |
p |
|---|---|---|---|---|
| Clinical response on day 3–5 | 9/20 (45%) | 17/31 (54.8%) | 61/119 (51.2%) | 0.472 |
| Microbiological response on day 3–5 | 7/12 (58%) | 17/25 (68%) | 32/54 (59%) | 0.736 |
| Needed change in antibiotic therapy after microbiological documentation | 0/5 (0%) | 4/20 (20%) | 18/76 (23.7%) | 0.344 |
| End of treatment clinical success | 16/20 (80%) | 17/31 (54.8%) | 69/119 (57.9%) | 0.143 |
| End of treatment clinical success in CSF culture negative cases | 11/13 (85%) | 8/11 (73%) | 26/34 (76%) | 0.762 |
| End of treatment clinical success in CSF culture in carbapenem-sensitive Gram-negative bacteria | 0/1 (0%) | 5/6 (83.3%) | 22/31 (70.9%) | NA |
| End of treatment clinical success in CSF culture in lumbar or ventricular rainage cases (ijncluding those with shunts at the time of diagnosis) | 8/9 (88.9%) | 10/17 (58.8%) | 28/58 (48.3%) | 0.069 |
| End of treatment clinical success in carbapenem-resistant Gram-negative bacteria | 0/0 (0%) | 0/4 (0%) | 0/18 (0%) | NA |
| End of treatment clinical success in methicillin-resistant staphylococci | 4/4 (100%) | 1/5 (20%) | 14/19 (73.7%) | NA |
| End of treatment clinical success in ampicillin-resistant enterococci | 0/0 (0%) | 1/1 (100%) | 0/4 (0%) | NA |
| Mortality due to any reason at EOT | 2/20 (10%) | 7/31 (22.5%) | 23/119 (19.3%) | 0.489 |
| Infection related mortality at EOT | 2/20 (10%) | 5/31 (16.1%) | 16/119 (13.4%) | 0.821 |
| Day 30 (after empirical treatment start) all cause mortality | 3/20 (15%) | 7/31 (22.6%) | 31/119 (26%) | 0.551 |
| Day 30 (after empirical treatment start) all cause mortality in microbiologically confirmed cases | 2/7 (28.6%) | 6/20 (30%) | 26/85 (30.6%) | 0.993 |
| Day 30 (after empirical treatment start) all cause mortality in microbiologically unconfirmed cases | 1/13 (7.7%) | 1/11 (9,1%) | 5/34 (14.7%) | 0.759 |
| All cause mortality among cases with EOT success, 30 days follow up after EOT | 1/16 (5.55%) | 0/17 (0%) | 12/69 (17.39%) | 0.101 |
| Overall clinical success | 13/20 (65%) | 16/31 (51.6%) | 54/119 (45.3%) | 0.252 |
| Overall clinical success in any microbiologically unconfirmed meningitis | 9/14 (64.2%) | 6/11 (54.5%) | 22/38 (57.8%) | 0.874 |
| Overall clinical success in any microbiologically confirmed meningitis | 4/6 (66.6%) | 10/20 (50%) | 32/81 (39.5%) | 0.337 |
| Reinfection during one month follow up among cases with EOT success | 0/16 (0%) | 0/17 (0%) | 2/69 (2.89%) | 0.613 |
| Relapse during one month follow up among cases with EOT success | 0/16 (0%) | 1/17 (5.88%) | 1/69 (1.44%) | 0.411 |
| Any sequalae | 0 (0%) | 0 (0%) | 33 (27.8%) | 0.00015 |
| Hematoma | 0 (0%) | 0 (0%) | 2 (1.7%) | 0.648 |
| Hydrocephalus | 0 (0%) | 0 (0%) | 3 (2.5%) | 0.519 |
| Abscess | 0 (0%) | 0 (0%) | 7 (5.9%) | 0.209 |
| Disorder of cognitive functions | 0 (0%) | 0 (0%) | 10 (8.4%) | 0.102 |
| Hemiparesis/hemiplegia | 0 (0%) | 0 (0%) | 9 (7.6%) | 0.152 |
| Any adverse effect | 1 (5%) | 4 (12.9%) | 6 (5%) | 0.222 |
| Antibiotic switch due to side effects | 0 (0%) | 1 (3.2%) | 1 (0.8%) | 0.478 |