Combination therapy with ciprofloxacin and third-generation cephalosporin versus third-generation cephalosporin monotherapy in Escherichia coli meningitis in infants: a multicentre propensity score-matched observational study

Tauzin et al, Clin Micro­bi­ol Infect. 2018 Dec 26

Abstract

OBJECTIVES:

Escherichia coli is the sec­ond cause of bac­te­r­i­al menin­gi­tis in neonates. Despite the use for 35 years of third-gen­er­a­tion cephalosporins (3GCs), high mor­bid­i­ty and mor­tal­i­ty rates with E. coli menin­gi­tis con­tin­ue to occur. Because ciprofloxacin has good micro­bi­o­log­i­cal activ­i­ty against E. coli and good pen­e­tra­tion in cere­brospinal flu­id and brain, some authors have sug­gest­ed adding ciprofloxacin to a 3GC reg­i­men. The objec­tive of this study was to assess com­bin­ing 3GCs with ciprofloxacin ver­sus 3GCs alone in a cohort of infants with E. coli menin­gi­tis.

CONCLUSIONS:

Ciprofloxacin added to 3GCs at least offers no advan­tage for neu­ro­log­i­cal out­come and mor­tal­i­ty in infants with E. coli menin­gi­tis.