title: Failure of cefotaxime in the treatment of meningitis due to relatively resistant Streptococcus pneumoniae.
abstract: 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.
authors.affiliation: Servico de Neurología, Hospital Universitario San Carlos, Madrid, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Catalán
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández
authors.forename: A
authors.initials: A
authors.lastname: Vazquez
authors.forename: E
authors.initials: E
authors.lastname: Varela de Seijas
authors.forename: A
authors.initials: A
authors.lastname: Suárez
authors.forename: J C
authors.initials: JC
authors.lastname: Bernaldo de Quirós
mesh_terms: 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
chemical_list: D014640:Vancomycin; D002439:Cefotaxime