DESPITE the availability of an effective therapy, the prognosis of pneumococcal meningitis has been quite variable from one institution to another, even in recent years. Lepper and Spies 1 reported a 10% case fatality rate for 68 patients. Olsson et al2 recorded 65% deaths in 43 cases. Swartz and Dodge 3 had 29% mortality for 56 cases. Since the therapeutic regimens in these hospitals were similar, the differences in outcome must have been due to differences in case material. For example, age is an important characteristic in relation to results. The series with the lowest fatality rate 1 had a large proportion of young patients while the series with the highest mortality rate 2 had many old patients.
Barring changes in admission policy, trends in prognosis for a given disease at a single institution over a period of time are likely to reflect the influence of changes in therapy