DOOR TO NEEDLE TIME ESTIMATION IN ACUTE BACTERIAL MENINGITIS

ABSTRACTS
Objective: The objective of this study was to determine the current door to needle time in acute bacterial meningitis.
Material and Methods: The descriptive study was carried out at the Department of Medicine Hayat Abad medical
complex Peshawar from 15 March 2015 to 31st march 2016 after ethical approval. After informed written consent from
patient or guardian 90 patients of either gender aged 15 to 60 years were enrolled in this study fulfilling the inclusion
criteria, having clinical features of meningitis, e.g. fever, headache, neck stiffness with altered mental status with CSF
Showing elevated protein (>100mg/dl), decreased glucose (>50mg/dl), and leukocytosis (>100 leukocytes) with
more than 80% neutrophils.
Door to needle time was estimated from time of arrival at emergency department printed on emergency slip to time of
administration of first dose of intravenous antibiotic. The patients were grouped into eleven categories for I.V antibiotics
delay. Each grouped spanned 60minutes.
Variables were recorded in restructured proforma. Statistical Package of Social Sciences (SPSS) version 11.0 was
used for descriptive statistics such as age, gender, clinical features, time of arrival, time of lumber puncture, and time
of I.V antibiotic administration.
Results: A total of 90 patients were recruited in this study. Male gender dominated 50(56%) female patients were
40(44%). Mean age was 29 years ranging from 15 years to 57 years. The patients were grouped into eleven categories
for I.V antibiotics delay. Each grouped spanned 60minutes. 3.3% received I.V antibiotics in first hour, 3.3% in 1 to 2
hour, 4.4% in 2 to 3hours, 3.3% in 3 to 4 hours, 7.7% in 4 to 5 hours, 10% in 5 to 6 hours, 13.3% in 6 to 7 hours, 15.5%
in 7 to 8 hours, 16.6% in 8 to 9 hours, 12.2% in 9 to 10 hours and 10% >10 hours (Graph 1).
Conclusion: acute bacterial meningitis is medical emergency. First dose antibiotic is significantly delayed in are setup.
Key Word: Acute Bacterial Meningitis, Door to Needle Time