[The role of meropenem in bacterial meningitis].
Meropenem is a new carbapenem antibiotic of with an antibacterian spectrum similar to that of imipenem, but from which it may mainly be differentiated by the possibility of its administration at high doses and it has no demonstrated proconvulsive effect, properties which make it applicable in the treatment of bacterial meningitis. The clinical and experimental experience in the treatment of bacterial meningitis with this antibiotic is herein reviewed. It has been observed that the efficacy and safety of meropenem in meningitis caused by N. meningitidis, H. influenzae and pneumococci sensitive to penicillin may be similar to that of cefotaxime or ceftriaxone in both the pediatric and adult population. There are very few reports on the treatment of meningitis caused by pneumococci resistant to penicillin. However, given that the activity of meropenem on these pneumococci is similar to that of cefotaxime and that the doses administered are much lower, it does not appear to be recommendable in the treatment of this indication, although it should be tested in all meningeal strain to these characteristics isolated. It may currently be considered that the main indication of meropenem in the infections of the central nervous system is in nosocomial meningitis by multiresistant gram negative bacilli such as those of the Klebsiella-Serratia-Enterobacter and Acinetobacter sp. group. Therefore a limited, albeit favorable, report on the clinical experience with meropenem is herein presented. Meropenem may also be useful in the treatment of meningitis by Pseudomonas aeruginosa in which other treatments have failed.
Fernández Viladrich
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P
Servicio de Enfermedades Infecciosas, Hospital de Bellvitge, Barcelona.
D000328:Adult; D000818:Animals; D001812:Blood-Brain Barrier; D002648:Child; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D004195:Disease Models, Animal; D006801:Humans; D016920:Meningitis, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D000077731:Meropenem; D011817:Rabbits; D013845:Thienamycins / Q000493:pharmacokinetics / Q000627:therapeutic use*
D013845:Thienamycins; D000077731:Meropenem