Sir.—We were pleased to see the recent study by Bonadio and associates1 confirming our previous report that Haemophilus influenzae is a common cause of bacterial meningitis in older children.2 In our study, six (21%) of 29 school-aged children with bacterial meningitis had H influenzae meningitis.
Meningitis caused by H influenzae was not limited to younger children. Haemophilus influenzae was isolated in one of three 9-year-old children with bacterial meningitis, one of two 11-year-olds, and one of three 12-year-olds with bacterial disease.2 Our findings and those of Bonadio and colleagues emphasize that empiric treatment ofpresumed bacterial meningitis in older children should include adequate coverage for H influenzae.