Alternative antibiotics for the treatment of bacterial meningitis in children: a systematic review of efficacy and safety.

Objective: This systematic review aimed to evaluate the efficacy and safety of alternative antibiotics and different standard treatment regimens for bacterial meningitis in children, considering the increasing antimicrobial resistance and the need for adapted therapeutic options. To justify the use of alternative antibiotics, the authors analyzed the specific efficacy of ampicillin, chloramphenicol, cefuroxime and meropenem, which showed potential to overcome cases of antimicrobial resistance.

Data sources: A search was performed in databases such as PubMed, Scopus, Web of Science and Cochrane Library, without data restrictions, including planned clinical trials that compared alternative antibiotics and different standard treatment regimens, such as ceftriaxone, in children with bacterial meningitis. Inclusion criteria include studies reporting cure rates, complications and safety of treatments.

Summary of results: An analysis of 14 studies, totaling 2,014 children, indicated that antibiotics such as ampicillin, chloramphenicol, cefuroxime and meropenem had comparable efficacy and safety to standard treatment regimens. The review showed that, in many cases, alternative regimens and shorter treatment durations could be effective, without significantly increasing complications or mortality.

Conclusion: The results suggest that alternatives to standard treatment, such as ampicillin, chloramphenicol, cefuroxime and meropenem, are viable and safe options for the treatment of bacterial meningitis in children. These results help to adapt clinical practices, especially in settings with high antimicrobial resistance and resource limitations, by providing evidence for shorter and equally effective treatment regimens.