| Summary: | Purpose: Central nervous system(CNS) infection is the most common cause of fever associate with signs and symptoms of CNS disease in children. Many organisms can cause these infections, but viral is the most common, then bacterial which is more common than parasitic and fungal infections. The most common three organisms are Haemophilus influenza type b(Hib), streptococcus pneumonia and Nieseria meningitis. Treatment should start as soon as possible in bacterial meningitis with antibiotics, but there is no need for antibiotics in viral meningitis. The antibiotics used third generation cephalosporines, penicilinge G, vancomycin, chloramphenicol .the duration of therapy ranges from 7-14 days, but in case of vancomycin it ranges from 5-7 days. The aims of this study were; to estimate the role of vancomycin in treatment of meningitis, to evaluate the role of antibiotics used in treatment of meningitis with special focus on vancomycin, to elaborate a guideline ladder for meningitis treatment depend on the type of organism and to establish a reliable and applicable plane for diagnosis of meningitis in Gaza.
Material and Methods: The study conducted in Dorrah Hospital in Gaza between 1/9/2011 and ndash; 31/11/2011 designed retrospective study. All the archives for children diagnosed meningitis in this period were included in this study. The total number of patients was (85), of whom two were excluded .one died after two hours of hospital arrival and the other due to incomplete information in the archive. The data collected were tabulated and analyzed with spss version 13. The value of P 0,05 were considered statistically significant. We used independent T- test to compare between means.
Results: All the cases treated whether using vancomycin or without vancomycin were improved. There were no difference between patients used vancomycin with other drugs and those do not use it, conversely patients do not receive vancomycine have better outcome. This means most of the cases do not need vancomycin as essential therapy. We found that the outcome regarding to the hospital stay was better in patients who do not treated with vancomycin. This confirmed by (58%) stayed in the hospital 5-7 days or less and 28% stayed 4 days or less. In general 86% of cases stayed less than 8 days. The study in case of bacterial infection, the number of cells in CSF is higher than a septic , while the sugar elevation is higher than in the aseptic form of meningitis and the culture is negative. The results revealthat the majority of cases were aseptic 71% with the cells number below 300. This result is confirmed by the criteria considered for a septic meningitis in Nelson text book of pediatrics. The study found that meningitis affects small age children and most of cases present in the age range from 3,1 month and 5 years, 56% of cases aged between 3,1- 24 month and 20% aged 24,1-60 month. The total percent is 76% ranges from 3,1-60 month.
Conclusion: After the previous discussion of the results obtained from this study, the researchers concluded that most of the cases diagnosed meningitis was aseptic and there was no need for antibiotics. Also in those who diagnosed as bacterial vancomycin was not essential in all cases, this confirmed by the absence of any differences in the outcome. [Cukurova Med J 2014; 39(3.000): 501-511]
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