We are once more indebted to the Barcelona Meningococcal Disease Surveillance Group1 for a further study based on patients enrolled in their ongoing study of meningococcal infections. In their prior publication,2 the authors asserted that preadmission antibiotics significantly decreased the risk of a fatal outcome. In response to a query,3 the authors expanded their presentation of data to reveal that (1) preadmission antibiotic therapy occurred more frequently in subacute and acute presentations and (2) a statistically significant effect on mortality of preadmission antibiotics occurred only in the acute and not in either the subacute or fulminant forms of disease.4 Apparently using the same cohort of patients, the authors now conclude that preadmission antibiotics not only improve mortality but also decrease the incidence of morbidity in survivors. The types of sequelae that were lessened in severity or prevented by this protective effect are not delineated. In both publications, the preadmission antibiotics were given solely for an upper respiratory tract infection (URI) and without any suspicion of meningococcal infection.
Radetsky M. Oral Antibiotics and Outcome in Meningococcemia. Arch Intern Med. 2000;160(14):2220-2221. doi: