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• W2088638049 abstract "Drs. Thurston, Hauhart and Dirgo are concerned about the potential toxicity of glycerol in the treatment of childhood bacterial meningitis. The question has puzzled us too. Glycerol was an established although “old-fashioned” method to lower increased intracranial pressure in adult medicine. Several studies comment on its clinical innocuousness,1-3 especially if administered orally, albeit detailed biochemical follow-up has thus far not been performed. Adverse reactions have been usually found in context with intravenous use.4,5 Glycerol is also used in countless products taken orally every day, including candies (“food-substance”1). The amount is small but obviously true toxicity, if it exists, cannot be dramatic. Dr. Thurston and collaborators give data showing that an intramuscular or intraperitoneal injection of glycerol increases the concentration of alpha-glycerophosphate in the liver and kidney of fasted rats. Adenosine triphosphate levels decreased by around 50%. The same held true in perfused rat liver and in suckling mice. However, what is the clinical relevance of these experimental animal studies? Transient biochemical, sometimes spectacular, alterations are associated with many treatments. One must show those alterations harmful enough to contra-indicate the treatment that might prevent permanent injury. In this case the theoretical consequences of transiently impaired nucleotide metabolism must be weighed against deafness; significant hearing impairment follows pneumococcal meningitis in 30% of those infected. One has to put these things in scale. All information on possible adverse effects is of course needed. We strongly advocate thorough toxicologic and other evaluations of glycerol as we said in our paper, and we also will try to assess these in future studies. Based on available literature, oral is safer than parenteral administration and the dose we used could possibly be decreased. Heikki Peltola, M.D.; Terhi Kilpi, M.D. Children's Hospital Helsinki, Finland" @default.
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• W2088638049 date "1996-01-01" @default.
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• W2088638049 title "IN REPLY: GLYCEROL TREATMENT IN BACTERIAL MENINGITIS" @default.
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• W2088638049 doi "https://doi.org/10.1097/00006454-199601000-00029" @default.
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