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Parenteral antibiotic given by general practitioners was associated with a substantial reduction in mortality(from 9%to 5%;relative risk 0-6,95% confidence interval 0.2 to 1.5);patients with a rash were more likely to be given parenteral antibiotics,and mortality was further reduced(from 12% to 5%;0.5,0.2 to 1.4).In a district where such treatment was regularly encouraged its use increased from 5%to 40%of cases over 10 years(p=0. 00001).Treatment with parenteral antibiotics before admission made isolation of meningococci from blood and cerebrospinal fluid less likely but did not affect nasopharyngeal cultures.Conclusions-General practitioners should carry benzylpenicillin in their emergency bags at all times and should administer it promptly,preferably intravenously,whenever meningococcal disease is suspected,unless the patient had had an anaphylactic reaction to penicillin.Specimens for culture should include a nasopharyngeal swab. |
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antibiotics meningitis meningitis,antibacterial treatment in meningitis,bacterial meningitis,children meningitis,meningococcal meningitis,neurologic aspects and complications of meningitis,treatment of mortality penicillin prognosis treatment of neurologic disorder
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