title: Penicillin-resistant pneumococcal meningitis in Israel.
abstract: Penicillin-resistant Streptococcus pneumoniae (PRP) is of worldwide concern. Treatment failures and fatalities of meningitis caused by PRP have been reported in other locations but not yet in Israel. We describe an 11-month-old infant with meningitis caused by PRP who failed to respond to initial treatment with cefotaxime. Vancomycin treatment caused a prompt cure. The minimal inhibitory concentrations of the isolate to penicillin, cefuroxime and cefotaxime were 1.0, 4.0 and 1.0 micrograms/ml, respectively. New guidelines for the treatment of meningitis in Israel are suggested.
authors.affiliation: Department of Pediatrics, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
authors.forename: T
authors.initials: T
authors.lastname: Steinberg
authors.forename: A
authors.initials: A
authors.lastname: Rachmel
authors.forename: Z
authors.initials: Z
authors.lastname: Samra
authors.forename: S
authors.initials: S
authors.lastname: Ashkenazi
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002439:Cefotaxime / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology; D006801:Humans; D007223:Infant; D007557:Israel; D008297:Male; D008586:Meningitis, Pneumococcal / Q000188:drug therapy* / Q000503:physiopathology; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D014640:Vancomycin / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D014640:Vancomycin; D002439:Cefotaxime