MENINGITIS: Standard treatment may be a killer

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MENINGITIS: Standard treatment may be a killer

 

Most doctors will give a child with suspected meningitis an immediate

penicillin injection before calling an ambulance. It’s almost become

standard practice, and every doctor carries around penicillin shots in

case of a meningitis emergency.

But it’s a practice that could kill the child, new research has discovered.

Children who are given penicillin are over seven times more likely to

die than children who weren’t given the shot before getting to hospital.

And those who survive are then five times more likely to suffer a

serious complication.

This alarming discovery was made when researchers tracked the progress

of 158 children who had been diagnosed with meningococcal disease, named

after the virus that causes meningitis and septicaemia.

It’s the second research paper to suggest that children given penicillin

are more likely to die – but why? There are two possible reasons: it

could be that doctors are vaccinating children whose meningitis seems to

be more severe, and so they were the ones more likely to die or suffer

complications in any event. The second, and more worrying, possibility

is that the children are reacting to the penicillin. The body may go

into shock when the penicillin releases toxic compounds known as endotoxins.

These findings place an enormous ethical responsibility on the shoulders

of doctors when they are faced with a case of meningitis – should they

vaccinate or not?

While there is growing evidence that penicillin may be doing harm, there

seems very little that suggests it is doing any good. Even in cases of

life-threatening meningitis, the dictum ‘first do nothing’ may become a

realistic option.

(Source: British Medical Journal, 2006; 332: 1295-8).