Failure of cefotaxime treatment in two children with meningitis caused by highly penicillin-resistant Streptococcus pneumoniae.
Two infants, aged 8.5 and 11 months, were admitted for meningitis caused by Streptococcus pneumoniae. Failure of cefotaxime led to the identification of highly penicillin-G-resistant strains. Minimum inhibitory concentrations (MICs) for penicillin were > 2 micrograms/ml, and cefotaxime MICs were 2 micrograms/ml. Both patients rapidly responded to a combination of i.v. imipenem and rifampicin. It is now mandatory to test in-vitro susceptibilities of Streptococcus pneumoniae to penicillin G and other beta-lactam agents when meningitis is diagnosed in infants.
Guibert
M
M
Laboratoire de Microbiologie, Hôpital Antoine Béclère, Clamart, France.
Chahime
H
H
Petit
J
J
Odièvre
M
M
Labrune
P
P
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002439:Cefotaxime / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D008586:Meningitis, Pneumococcal / Q000188:drug therapy*; D010403:Penicillin Resistance; D012293:Rifampin / Q000008:administration & dosage*; D013296:Streptococcus pneumoniae / Q000187:drug effects; D013845:Thienamycins / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D013845:Thienamycins; D015378:Imipenem; D002439:Cefotaxime; D012293:Rifampin