title: Bactericidal activity against intermediately cephalosporin-resistant Streptococcus pneumoniae in cerebrospinal fluid of children with bacterial meningitis treated with high doses of cefotaxime and vancomycin.
abstract: Cerebrospinal fluid (CSF) was taken from 19 children with bacterial meningitis treated with cefotaxime (300 mg/kg of body weight/day) and vancomycin (60 mg/kg/day). Median levels of drugs in CSF were smaller than expected, as follows: 4.4 microg/ml for cefotaxime, 3.2 microg/ml for desacetylcefotaxime, and 1.7 microg/ml for vancomycin. The median CSF bactericidal titer against an intermediately cefotaxime-resistant pneumococcus was 1:4. Our data suggest at least an additive interaction between the drugs used in this study.
authors.affiliation: Service de Microbiologie, Hôpital Robert Debré, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Doit
authors.forename: J
authors.initials: J
authors.lastname: Barre
authors.forename: R
authors.initials: R
authors.lastname: Cohen
authors.forename: S
authors.initials: S
authors.lastname: Bonacorsi
authors.forename: A
authors.initials: A
authors.lastname: Bourrillon
authors.forename: E H
authors.initials: EH
authors.lastname: Bingen
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000134:cerebrospinal fluid* / Q000627:therapeutic use*; D002439:Cefotaxime / Q000134:cerebrospinal fluid* / Q000627:therapeutic use*; D018550:Cephalosporin Resistance; D002511:Cephalosporins / Q000134:cerebrospinal fluid* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D006801:Humans; D007223:Infant; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid* / Q000188:drug therapy*; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections; D013296:Streptococcus pneumoniae; D014640:Vancomycin / Q000134:cerebrospinal fluid* / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D014640:Vancomycin; D002439:Cefotaxime