title: Appearance of resistance to beta-lactam antibiotics during therapy for Streptococcus pneumoniae meningitis.
abstract: A young boy had meningitis caused by Streptococcus pneumoniae that was relatively resistant to penicillin and susceptible to cefotaxime. After 10 days of therapy with penicillin and cefotaxime, fever recurred and a second lumbar puncture revealed a pneumococcus that was resistant to all beta-lactam antibiotics. We now add vancomycin to empiric third-generation cephalosporin therapy for meningitis in children when gram-positive cocci are seen on the cerebrospinal fluid smear.
authors.affiliation: Department of Pediatrics, Virgen Rocio Children's Hospital, Seville University School of Medicine, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Muñoz
authors.forename: E S
authors.initials: ES
authors.lastname: Valderrabanos
authors.forename: E
authors.initials: E
authors.lastname: Diaz
authors.forename: J J
authors.initials: JJ
authors.lastname: Silva
authors.forename: J A
authors.initials: JA
authors.lastname: Soult
authors.forename: P
authors.initials: P
authors.lastname: Infante
authors.forename: J D
authors.initials: JD
authors.lastname: Lopez
authors.forename: A
authors.initials: A
authors.lastname: Garcia-Curiel
mesh_terms: D002444:Cefuroxime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D008297:Male; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000209:etiology*; D010406:Penicillins / Q000627:therapeutic use; D013296:Streptococcus pneumoniae / Q000472:pathogenicity*; D014640:Vancomycin / Q000627:therapeutic use; D018440:beta-Lactam Resistance
chemical_list: D002511:Cephalosporins; D010406:Penicillins; D014640:Vancomycin; D015378:Imipenem; D002444:Cefuroxime