Table 1.
Case fatality for confirmed pneumococcal meningitis by period (defined by empiric antibiotic therapy)
| Characteristic | Time period a | Total | ||||||
|---|---|---|---|---|---|---|---|---|
| Dec 1995--Nov 1998 | Dec 1998--Nov 2002 | Dec 2002--Nov 2005 | ||||||
| N = 209 | N = 220 | N = 119 | ||||||
| Cases | Deaths (% CFR) | Cases | Deaths (% CFR) | Cases | Deaths (% CFR) | Cases | Deaths (% CFR) | |
| Age category | ||||||||
| <30 days | 4 | 3 (75.0) | 1 | 1 (100) | 0 | -- | 5 | 4 (80) |
| 30-364 days | 76 | 53 (69.7) | 86 | 42 (48.8) | 22 | 10 (45.4) | 184 | 105 (57.1) |
| 1-4 years | 23 | 13 (56.5) | 19 | 6 (31.6) | 13 | 8 (61.5) | 55 | 27 (49.1) |
| 5-14 years | 38 | 2 (5.3) | 39 | 6 (15.4) | 21 | 2 (9.5) | 98 | 10 (10.2) |
| 15-49 years | 56 | 18 (32.1) | 65 | 11 (16.9) | 46 | 10 (21.7) | 167 | 39 (23.3) |
| 50 years or older | 12 | 7 (58.3) | 10 | 3 (30) | 17 | 8 (47.1) | 39 | 18 (46.1) |
| Initial antibiotic therapy | ||||||||
| Ampicillin or penicillin b | 124 | 46 (37.1) | 40 | 6 (15.0) | 5 | 0 (0) | 169 | 52 (30.8) |
| Ceftriaxone | 68 | 37 (54.4) | 148 | 50 (33.7) | 108 | 37 (34.3) | 324 | 124 (38.3) |
| Ceftriaxone + Vancomycin | 1 | 0 (0) | 20 | 5 (25) | 1 | 0 (0) | 22 | 5 (22.7) |
| Other/Unknown | 16 | 12 (75) | 12 | 9 (75) | 5 | 1 (20) | 33 | 22 (66.7) |
| Discordant therapy c | ||||||||
| Yes | 14 | 7 (50) | 7 | 3 (42.9) | 1 | 0 (0) | 22 | 10 (45.5) |
| No | 195 | 90 (46.2) | 213 | 66 (30.9) | 118 | 38 (32.2) | 526 | 193 (36.7) |
| Pneumococcal isolate resistant to penicillind | 29 | 17 (58.6) | 37 | 18 (48.6) | 23 | 9 (39.1) | 92 | 44 (47.8) |
a Study period was divided into three periods for the purposes of this analysis: empiric therapy containing a penicillin (December 1995-November 1998), transition period (December 1998-November 2002) and empiric therapy with ceftriaxone (December 2002-November 2005).
b Includes regimens with ampicillin in combination with chloramphenicol or an aminoglycoside. A small proportion of patients received crystalline penicillin G in place of ampicillin.
c Antibiotic therapy was defined as discordant when patients did not receive a β-lactam antibiotic for which the S. pneumoniae isolate was susceptible during the initial 24 hours of hospitalization.
d Defined as penicillin MIC >0.06 μg/ml for a pneumococcal isolate from a patient with meningitis.