Failure of cefotaxime in the treatment of meningitis due to relatively resistant Streptococcus pneumoniae.
To our knowledge, we report the first failure of cefotaxime in the treatment of meningitis due to relatively resistant Streptococcus pneumoniae (MICs of penicillin and cefotaxime, 1 microgram/mL). Cure was achieved with a 14-day course of intravenous and intrathecal vancomycin. We recommend that in cases of meningitis caused by strains of S. pneumoniae for which MICs are > or = 1 microgram/mL, cefotaxime should be used with caution; however, if therapeutic failure is suspected therapy should be changed to intravenous and intrathecal vancomycin.
Catalán
M J
MJ
Servico de Neurología, Hospital Universitario San Carlos, Madrid, Spain.
Fernández
J M
JM
Vazquez
A
A
Varela de Seijas
E
E
Suárez
A
A
Bernaldo de Quirós
J C
JC
D000328:Adult; D002439:Cefotaxime / Q000494:pharmacology / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D006801:Humans; D007275:Injections, Intravenous; D007278:Injections, Spinal; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy*; D010403:Penicillin Resistance; D013290:Streptococcal Infections / Q000188:drug therapy*; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use
D014640:Vancomycin; D002439:Cefotaxime