Killing activity of cefpirome against penicillin-resistant Streptococcus pneumoniae isolates from patients with meningitis in a pharmacodynamic model simulating the cerebrospinal fluid concentration profile.
An in vitro pharmacodynamic model was used to determine the killing kinetics of cefpirome against 20 Streptococcus pneumoniae strains (penicillin G MICs, > 0.125 to 2 micrograms/ml) isolated from patients with meningitis. The concentration of cefpirome was adjusted dynamically to simulate the median concentration profile obtained in the cerebrospinal fluid of adults after the infusion of a single dose of 2 g. The cefpirome MIC at which 90% of isolates are inhibited was 0.5 microgram/ml. Bactericidal activity was observed at 6 h, with mean killing of 3.51 +/- 0.34 log10 CFU/ml for all strains for which the cefpirome MIC was < 0.5 microgram/ml. In contrast, for strains for which the cefpirome MIC was > or = 0.5 microgram/ml, killing was significantly less (P < 0.05), with a mean reduction of only 2.86 +/- 0.57 log10 CFU/ml.
Fitoussi
F
F
Service de Microbiologie, Hôpital Robert Debré, Paris, France.
Doit
C
C
Sandin
A
A
Pechinot
A
A
Kazmierczack
A
A
Geslin
P
P
Bingen
E
E
D000328:Adult; D002443:Ceftriaxone / Q000494:pharmacology; D002511:Cephalosporins / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics / Q000494:pharmacology*; D006801:Humans; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid / Q000382:microbiology*; D010403:Penicillin Resistance / Q000502:physiology*; D010406:Penicillins / Q000494:pharmacology; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D000097572:Cefpirome
D002443:Ceftriaxone; D002511:Cephalosporins; D010406:Penicillins; D000097572:Cefpirome