Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Exploring Link Between Antibiotic Use and Meningitis
BMJ Open; 2017 Nov 15; Cars, et al
Reducing the use of antibiotics in patients with upper respiratory tract infections (URTIs) has not increased the incidence of meningitis, invasive group A streptococcal disease, ethmoidal sinusitis, or several other complications, according to a 10-year analysis of patient records. Among the findings:
- Antibiotic usage for respiratory tract infections dropped by 22% from 2006 to 2015.
- Meningitis and ethmoidal sinusitis infections decreased during the same period (P=0.0038 and P=0.0003, respectively.)
- Overall, after URTIs, bacterial complications were about as uncommon in patients given antibiotics as were the complications in those who didn’t receive the drugs: <1.5/10,000 episodes vs <1.3/10,000 episodes.
Cars TC, Eriksson I, Granath A, et al. Antibiotic use and bacterial complications following upper respiratory tract infections: A population-based study. BMJ Open. 2017;15:e016221. doi:10.1136/bmjopen-2017-016221.
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Cerebral Venous Thrombosis & Steroids in Meningitis, Open Forum Infect Dis; 2017 Oct; Gallegos, et al
Early Onset GBS Meningitis Drops, Late Onset Jumps, Clin Infect Dis; 2017 Oct 16; Romain, et al
Better Diagnostic Tests for Histoplasma Meningitis, Clin Infect Dis; 2017 Aug 20; Block, et al
Understanding Meningococcal Disease, Asian Pac J Trop Med; 2017 Nov; Batista, et al
Cryptococcal Meningitis Takes Toll on HIV Patients, Clin Infect Dis; 2017 Oct 4; Pasquier, et al
The use of antibiotics contributes to the emergence and spread of antibiotic-resistant bacteria. Antimicrobial stewardship is an emerging field to curb unnecessary use of antibiotics. Respiratory tract infections remain one of the most common reasons for prescribing antibiotics throughout the world, but when to use antibiotics for respiratory tract infections remains a challenge. The findings of this study are encouraging, as they indicate that reduced use of antibiotics for respiratory tract infections has not resulted in increased rates of complications. The reported decreased incidence of meningitis, however, was not from reduced use of antibiotics, but most likely from the introduction of protein-conjugated meningitis vaccines, such as conjugated pneumococcal vaccines, during the study period.
—Kwang Sik Kim, MD
Director, Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD
Professor of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD