title: Rationale for clinical trials evaluating ceftriaxone in the therapy of bacterial meningitis.
abstract: Ceftriaxone is a promising antimicrobial agent in the therapy of bacterial meningitis. The rationale for the clinical evaluation of ceftriaxone in patients with meningitis is based on the following favorable characteristics: ceftriaxone has excellent in vitro activity (MBC90 0.25 microgram/ml or less) against the major meningeal pathogens including meningococci, pneumococci, group B streptococci, Hemophilus influenzae, and Escherichia coli, but it is inactive against Listeria monocytogenes; ceftriaxone is rapidly bactericidal within purulent cerebrospinal fluid in experimental animal models of meningitis induced by pneumococci, group B streptococci, H. influenzae, and E. coli; against most of the major meningeal pathogens, the activity attained in cerebrospinal fluid in human subjects with bacterial meningitis is high (1:512 or greater) and active concentrations of ceftriaxone persist in cerebrospinal fluid for prolonged periods compared with those of other cephalosporins; the results of clinical trials reported to date in patients with meningitis are encouraging. Ceftriaxone deserves further clinical evaluation in the treatment of bacterial meningitis; the optimal dose, frequency of administration, and duration of therapy remain to be determined.
mesh_terms: D000818:Animals; D001424:Bacterial Infections / Q000188:drug therapy*; D002439:Cefotaxime / Q000031:analogs & derivatives* / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D002443:Ceftriaxone; D002511:Cephalosporins / Q000378:metabolism / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006193:Haemophilus influenzae / Q000187:drug effects; D006801:Humans; D007700:Kinetics; D008581:Meningitis / Q000188:drug therapy*; D008826:Microbial Sensitivity Tests
chemical_list: D002511:Cephalosporins; D002443:Ceftriaxone; D002439:Cefotaxime