High doses of cefotaxime in treatment of adult meningitis due to Streptococcus pneumoniae with decreased susceptibilities to broad-spectrum cephalosporins.

Abstract

We treated nine patients (10 episodes) with meningitis caused by Streptococcus pneumoniae isolates with decreased susceptibilities to broad-spectrum cephalosporins with high doses of cefotaxime (300 mg/kg of body weight per day; maximum dose, 24 g/day). Early adjunctive therapy with dexamethasone was also administered. Cefotaxime MICs were 0.5 (three episodes), 1 (five episodes), and 2 (two episodes) micrograms/ml, and MBCs ranged from 1 to 4 micrograms/ml. Therapy was well tolerated, and all patients experienced prompt clinical improvement. One patient died 8 days after the end of therapy, the central nervous system infection had already been cured, and the remaining patients recovered without relapses.

• Authors: P F Viladrich, C Cabellos, R Pallares, F Tubau, J Martínez-Lacasa, J Liñares, F Gudiol
• Journal: Antimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 40 Issue 1 Pg. 218-20 (Jan 1996) ISSN: 0066-4804 [Print] United States
• PMID: 8787909 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Cephalosporins
• Cefotaxime

Topics

• Adult
• Aged
• Cefotaxime (administration & dosage, cerebrospinal fluid, therapeutic use)
• Cephalosporin Resistance
• Cephalosporins (administration & dosage, cerebrospinal fluid, therapeutic use)
• Drug Administration Schedule
• Female
• Humans
• Male
• Meningitis, Pneumococcal (drug therapy, epidemiology, microbiology)
• Microbial Sensitivity Tests
• Middle Aged
• Spain (epidemiology)