BMJ  2006;332 (3 June), doi:10.1136/bmj.332.7553.0-a

...but such findings are likely to be confounded by disease severity

The effects of giving antibiotics before hospital admission to children with meningococcal disease are unclear, and observational studies are unlikely to provide conclusive evidence. A systematic review by Hahné and colleagues (p 1299) found 14 cohort studies of prehospital treatment. It seems that oral antibiotics were beneficial and some studies found that parenteral antibiotics were harmful, but the authors argue that these results are confounded by severity of the disease, which cannot be fully adjusted for. Only a randomised controlled trial could answer the research question.

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Effectiveness of antibiotics given before admission in reducing mortality from meningococcal disease: systematic review

Susan J M Hahné, André Charlett, Bernadette Purcell, Susanne Samuelsson, Ivonne Camaroni, Ingrid Ehrhard, Sigrid Heuberger, Maria Santamaria, and James M Stuart
BMJ 2006 332: 1299-1303. [Abstract] [Full Text] [PDF]

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