Sumarmo Sumarmo
Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta

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Experience with sulphamethoxazole (SMZ)/trimethoprim (TMP) combination in purulent meningitis not responding to conventional microbial therapy Sumarmo Sumarmo; Mugiyo K.; Mandoyono Mandoyono; Lauritha S. P.; Adji Suntoro
Paediatrica Indonesiana Vol 21 No 1-2 (1981): January - February 1981
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (679.8 KB) | DOI: 10.14238/pi21.1-2.1981.11-20

Abstract

Tell infants ranging in age from two days to nine months with purulent meningitis who were considered therapeutic failures after conventional microbial therapy (i.e. ampicillin, chloramphenicol, gentamicin, amikin, cloxacillin in any combination) were included in this study. A solution consisting of SMZ 80 mg/mL and TMP 16 mg/mL in propylene glycol (Bactrilll, Hoffman-La Roche A.G. Basle/Switzerland) was given intravenously to the patients. The daily dose was 10 mg/kg BW TMP/24 hours for the first three days followed by 6 mg/kg BW TMP/24 hours divided in two doses given intravenously every 12 hours.Nine patients recovered, 7 of them rapidly within 10 - 21 days after SMZ/TMP administration and the other 2 patients within 27 and 33 days respectively. One infant improved but died afterwards of complicatIons not related to the treatment.No hematological nor cutaneous and gastrointestinal side effects were observed. The liver and renal function test performed on 3 out of 10 cases on the first few days of the commencement of treatment and 3 weeks later, were all within normal limits.Our experience with the use of parenteral SMZ/TMP in infants with bacterial meningitis not responding to conventional microbial therapy gave encouraging results.
Treatment of Neonatal Purulent Meningitis with a Sulphamethoxazole (SMZ)/Trimethoprim (TMP) Combination Sumarmo Sumarmo; Mugiyo Mugiyo; Priutomo Priutomo; Sofyan Ismael; Muslim A. Nathin
Paediatrica Indonesiana Vol 22 No 7-8 (1982): July - August 1982
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi22.7-8.1982.119-25

Abstract

This paper describes our experience in treating neonatal meningitis with an intravenous Sulphametoxazole/Trimethoprim (SMZ-TMP) combination.Fifteen neonates ranging in age from 6 to 36 days were included in this study. Cerebrospiral fluid isolates were as follows:S. havana (3), S. oranienburg (2) and Haemolytic streptococci (1), the remaining 9 cultures were negative. Those bacteria isolated were all sensitive to SMZ/TMP. A solution of SMZ 80 mg/ml and TMP 16 mg/ml in 40% propylene glycol was used with a daily dose of 10 mgfkg B.W. TMP for the first 3 days followed by 6 mg/kg B.W. TMP for 18 days or longer, divided in two dose given intravenously every 12 hours.Thirteen patients recovered, but two died of neurological complications, one with ventriculitis and the other with a subdural empyema.No hematological or cutaneous or gastrointestinal side effects were observed. The liver and renal function tests performed on 5 out of the 15 patients on the first few days of hospitalization and 3 weeks later were all within normal lirnits. The use of parenteral SMZ-TMP in neonatal meningitis showed an encouraging result considering the fact rthat our previous mortality rate was 60%.