Therapeutic Approaches in Children with Invasive Meningococcal Disease (IMD) in Greece.

Background Invasive meningococcal disease (IMD) is an acute, severe infection that continues to pose a significant public health challenge worldwide because of its potential for mortality and long-term sequelae. Objectives This study aimed to assess therapeutic approaches focused on the use of first-line antibiotics as well as practices for dexamethasone treatment in patients with meningococcal meningitis in Greece. Methods A retrospective analysis was conducted on pediatric patients aged up to 16 years identified through laboratory records from the Hellenic National Meningitis Reference Laboratory (HNML) between 2010 and 2020. The data collected included age, treatment regimens, antibiotic susceptibility, and clinical outcomes. Results A total of 161 patients admitted to 9 hospitals across Greece were identified. The medical records of 91 (56.5%) patients were retrieved. The median age was 36 months. All the meningococcal isolates were susceptible to third-generation cephalosporins (ceftriaxone, cefotaxime), which are empirical treatments for 97.7% of the cases, whereas penicillin resistance was recorded in 15.2% of the isolates. The case fatality rate was 5.5% (5 cases). The administration of dexamethasone to 31 patients (34%) with meningococcal meningitis was associated with a nonsignificant reduction in adverse outcomes (12.9% vs. 29%). One fatal case occurred in the nondexamethasone group. Conclusion Third-generation cephalosporins are confirmed as effective empirical treatments for IMD in Greece. Owing to the small size of our cohort, the use of adjunctive dexamethasone was not significantly associated with improved outcomes in this cohort.