Aztreonam in the treatment of bacterial meningitis.
The monobactam aztreonam was used to treat 22 young patients with meningitis caused by gram-negative bacilli. Haemophilus influenzae was isolated from the CSF of 21 patients and Salmonella heidelberg from the CSF of 1. Dosages ranged from 100 to 200 mg/kg/day in 4 doses at 6-hour intervals. Minimal inhibitory concentrations were determined by the broth dilution method for all isolated strains, and values ranged from 0.05 to 2.0 micrograms/ml. Blood and CSF drug levels were determined by a microbiologic plate diffusion method, and mean values for CSF and blood were 1.4 and 14.9 micrograms/ml, respectively. The outcome was good in 21 patients; 1 patient died. Complications were mild; subdural effusion occurred in 6 cases and was managed clinically; asymptomatic hydrocephalus was seen in 4; seizure during the acute phase occurred in 6 cases; hypoacusis was noted in 2, and motor impairment was detected at the follow-up in 1 case. Aztreonam achieved good blood and CSF penetration and performed well in the treatment of 20 cases of H. influenzae meningitis and in the one case of S. heidelberg meningitis.
Ayroza-Galvão
P A
PA
Emilio Ribas Hospital, São Paulo, Brazil.
Milstein-Kuschnaroff
T M
TM
Mimica
I M
IM
Maassen
S
S
Barbosa Júnior
S P
SP
Cavalcante
N J
NJ
Lorenco
R
R
Mimica
L M
LM
Martino
M D
MD
D001398:Aztreonam / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008581:Meningitis / Q000188:drug therapy*; D008583:Meningitis, Haemophilus / Q000188:drug therapy; D012480:Salmonella Infections / Q000188:drug therapy
D001398:Aztreonam