Early prognostic value of repeat CSF parameter measurements in neonatal bacterial meningitis following initial antimicrobial therapy

For neonates with BM who have shown an adequate response to initial antimicrobial therapy, conducting repeated CSF examinations within the first 3-5 days of treatment appears to have limited value, as it does not provide additional information that could help physicians shorten the duration of antibiotic therapy or reduce the risk of short-term adverse outcomes, such as risk of complications during hospitalizations or sequelae at discharge. In contrast, for the initial assessment of short-term prognosis in neonates newly diagnosed with bacterial meningitis, the clinical global impression (CGI) at admission, particularly factors such as neonatal weight, neurological symptoms, response to initial antimicrobial therapy, and early laboratory data-including peak blood CRP levels before antibiotic use, initial CSF glucose levels, initial CSF protein levels, and blood culture. results [In Table 4, a comparison between neonates with an adequate response to therapy and those without revealed a significant difference in blood culture results (p = 0.025)] -have shown stronger predictive capabilities and deserve greater attention.