title: Listeria monocytogenes infections--therapeutic possibilities and problems.
abstract: Listeriosis in humans is a rare disease, which, however, is known to be epidemic and endemic. The prognosis has remained unsatisfactory up to today, the fatality being at least 10% and often considerably higher depending on the clinical features of the disease and the patient's age. Three population groups are at risk: pregnant women, fetuses and newborn infants. Furthermore, immunosuppression in older patients due to disease, therapy, or age also plays a role. The incidence of Listeria infections in patients over 45 is clearly increasing. Due to the nature of the pathogen (in vivo bactericidal concentrations of antibiotics are often not attainable; intracellular growth) a high dosage of ampicillin is recommended. Although the present therapeutic possibilities are not satisfactory, a combination of ampicillin and an aminoglycoside appears to be the best therapy at present. Other combinations such as rifampicin and beta-lactam antibiotics have exhibited in vitro antagonism. The preferred therapy, ampicillin, can only be recommended with reservations because it is not optimally effective.
mesh_terms: D000328:Adult; D000617:Aminoglycosides; D000667:Ampicillin / Q000008:administration & dosage / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005315:Fetal Diseases / Q000188:drug therapy; D006801:Humans; D007231:Infant, Newborn; D008088:Listeriosis / Q000188:drug therapy*; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D011379:Prognosis; D012307:Risk Factors
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000667:Ampicillin