{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T23:20:22Z","timestamp":1788218422324,"version":"build-2803163510"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T00:00:00Z","timestamp":1585872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100012641","name":"International Pediatric Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012641","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004212","name":"P\u00e4ivikki and Sakari Sohlberg Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004212","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006306","name":"Sigrid Jus\u00e9lius Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010135","name":"Finska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010135","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010119","name":"Stiftelsen Dorothea Olivia, Karl Walter och Jarl Walter Perkl\u00e9ns Minne","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010119","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007083","name":"Orion Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007083","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005744","name":"Lastentautien Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005744","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In our previous study in Luanda, Angola, initial continuous \u03b2-lactam infusion for 24 hours combined with oral acetaminophen for 48 hours showed promising results as a new treatment for childhood bacterial meningitis. We investigated whether extending this treatment regimen to 4 days would improve the outcomes further.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a randomized, double-blind, parallel-group study at the same hospital in Luanda. Children aged 2 months to 15 years presenting to hospital with symptoms and signs of bacterial meningitis were randomized to receive, for the first 4 days, a continuous infusion of cefotaxime (250 mg\/kg\/day) with simultaneous oral acetaminophen (first dose 30 mg\/kg, then 20 mg\/kg every 6 hours), or cefotaxime conventionally as boluses (62.5 mg\/kg, 4 times per day) with placebo orally. All children received also glycerol orally. The primary outcome was mortality by day 7.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In all, 375 patients were included in the study between 22 January 2012 and 21 January 2017. As 2 children succumbed before treatment initiation, 187 vs 186 participants remained in the intervention and control groups, respectively. On day 7, 61 of 187 (32.6%) children in the intervention group vs 64 of 186 (34.4%) in the control group had died (risk ratio, 0.95 [95% confidence interval {CI}, .71\u20131.26]; absolute risk difference, 1.8% [95% CI, \u22127.8 to 11.4]). At discharge from hospital, the corresponding numbers were 71 of 187 (38.0%) and 75 of 186 (40.3%), respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Prolonged continuous \u03b2-lactam infusion combined with oral acetaminophen did not improve the gloomy outcomes of childhood bacterial meningitis in Angola.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trials Registration<\/jats:title>\n                  <jats:p>NCT01540838.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa341","type":"journal-article","created":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T19:13:13Z","timestamp":1585854793000},"page":"1738-1744","source":"Crossref","is-referenced-by-count":22,"title":["Extended Continuous \u03b2-Lactam Infusion With Oral Acetaminophen in Childhood Bacterial Meningitis: A Randomized, Double-blind Clinical Trial"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8011-8276","authenticated-orcid":false,"given":"Okko","family":"Savonius","sequence":"first","affiliation":[{"name":"Children\u2019s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Rugemalira","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irmeli","family":"Roine","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University Diego Portales, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Leite","family":"Cruzeiro","sequence":"additional","affiliation":[{"name":"Hospital Pedi\u00e1trico David Bernardino, Luanda, Angola"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heikki","family":"Peltola","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuula","family":"Pelkonen","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland"},{"name":"Hospital Pedi\u00e1trico David Bernardino, Luanda, Angola"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,4,3]]},"reference":[{"key":"2021051810405314500_CIT0001","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1016\/S0140-6736(16)31575-6","article-title":"Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, 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