PRIOR to the use of specific antimeningococcic serum in treatment of patients by Flexner and Jobling1 in 1908, the therapy of meningococcic meningitis was symptomatic and was attended by a mortality rate of 20 to 90%. From then until the advent of chemotherapy, routine management consisted of frequent spinal drainage, adequate supportive care, and the injection of serum intrathecally, intravenously, or intramuscularly, or in combination of these routes. These procedures reduced the mortality rate to a range of 15 to 50%. As experience grew, the use of intrathecal therapy and frequent drainage was decried (Hoyne2; Tripoli3), the intramuscular and intravenous routes being advocated.
In 1936 the sulfonamides came into general use and in one form or another have supplanted serum therapy. Varying figures have been given for the relative efficacy of the different members of the sulfonamide group, but in general sulfadiazine is most favored because of
ROSS AT. MENINGOCOCCIC MENINGITIS: Incidence of Residua Following Serum, Sulfonamide, and Sulfonamide-Penicillin Therapy. AMA Arch NeurPsych. 1952;67(1):89–102. doi:10.1001/archneurpsyc.1952.02320130095010
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