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Table 1 Case fatality for confirmed pneumococcal meningitis by period (defined by empiric antibiotic therapy)

From: Clinical outcome of pneumococcal meningitis during the emergence of pencillin-resistant Streptococcus pneumoniae: an observational study

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 penicillin d 29 17 (58.6) 37 18 (48.6) 23 9 (39.1) 92 44 (47.8)
  1. 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).
  2. 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.
  3. 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.
  4. d Defined as penicillin MIC >0.06 μg/ml for a pneumococcal isolate from a patient with meningitis.