The clinical condition rather than cerebrospinal fluid parameters guides the optimal duration of antimicrobial therapy among neonates with bacterial meningitis: a single-center retrospective study

Abstract Background Neonatal bacterial meningitis is serious and accounts for high morbidity and mortality in developing countries, but the duration of antimicrobial treatment is not well established. We aimed to compare the clinical characteristics and outcomes of neonatal bacterial meningitis with normal cerebrospinal fluid (CSF) and abnormal CSF at discharge. Methods We enrolled neonates with bacterial meningitis who were admitted to the neonatology department of Children’s Hospital of Chongqing Medical University between August 1, 2019 and January 1, 2021. The children’s clinical data, laboratory data and outcomes were recorded and analyzed. Results Fifty-five neonates met the inclusion criteria in our study. Besides CSF protein levels, there was no significant difference in clinical symptoms, the blood parameters (white blood cell count, neutrophils, platelet, C-reaction protein, and procalcitonin), CSF WBC counts at admission and discharge period, the duration of antibiotics, and hospital stays between the two groups (P > 0.05). For the sequelae of bacterial meningitis, short-term and long-term complications also showed no statistically significant differences between the two groups. Conclusions The duration of antimicrobial therapy in neonatal bacterial meningitis depends on the clinical condition of the patient, rather than the CSF parameters. It may improve the reasonable utilization of the antibiotics in neonatal bacterial meningitis.