Comparison of cotrimoxazole, ampicillin, and chloramphenicol in treatment of experimental Haemophilus influenzae type B meningitis.
To evaluate cotrimoxazole in the treatment of bacterial meningitis, we compared its action with that of ampicillin and chloramphenicol in experimental Haemophilus influenzae type b meningitis. Both trimethoprim and sulfamethoxazole penetrated well into the cerebrospinal fluid of infected rabbits, reaching 40 and 26%, respectively, of their simultaneous serum levels. Levels measured 30 and 60 min after intravenous injection exceeded the minimum inhibitory concentration of this combination for H. influenzae by 10- to 100-fold. The mean ratio of trimethoprim to sulfamethoxazole in cerebrospinal fluid was 1:22. Cotrimoxazole was as effective as ampicillin in therapy of beta-lactamase-negative H. influenzae meningitis and as effective as chloramphenicol for a beta-lactamase positive strain. These findings corroborate favorable preliminary clinical experience reported by others and indicate that cotrimoxazole deserves further study in the therapy of bacterial meningitis.
D000667:Ampicillin / Q000097:blood / Q000134:cerebrospinal fluid / Q000627:therapeutic use*; D000818:Animals; D002701:Chloramphenicol / Q000097:blood / Q000134:cerebrospinal fluid / Q000627:therapeutic use*; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D006193:Haemophilus influenzae / Q000187:drug effects*; D008297:Male; D008583:Meningitis, Haemophilus / Q000188:drug therapy*; D008826:Microbial Sensitivity Tests; D011817:Rabbits; D013420:Sulfamethoxazole / Q000008:administration & dosage / Q000097:blood / Q000134:cerebrospinal fluid / Q000627:therapeutic use*; D013997:Time Factors; D014295:Trimethoprim / Q000008:administration & dosage / Q000097:blood / Q000134:cerebrospinal fluid / Q000627:therapeutic use*
D004338:Drug Combinations; D002701:Chloramphenicol; D000667:Ampicillin; D014295:Trimethoprim; D013420:Sulfamethoxazole