Cefepime is efficacious against penicillin- and quinolone-resistant pneumococci in experimental meningitis.
In experimental rabbit meningitis, cefepime given at a dose of 100 mg/kg was associated with concentrations in the cerebrospinal fluid of between 5.3 and 10 mg/L and a bactericidal activity of -0.61 +/- 0.24 Delta log(10) cfu/mL x h, similar to the standard regimen of ceftriaxone combined with vancomycin (-0.58 +/- 0.14 Delta log(10) cfu/mL x h) in the treatment of meningitis due to a penicillin- and quinolone-resistant pneumococcal mutant strain (MIC 4 mg/L). Compared with the penicillin-resistant parental strain, the penicillin- and quinolone-resistant mutant was killed more slowly by cefepime and ceftriaxone in time-killing assays in vitro over 8 h.
Cottagnoud
Philippe
P
Department of Internal Medicine, Inselspital, 3010 Bern, Switzerland. pcottagn@insel.ch
Acosta
Fernando
F
Cottagnoud
Marianne
M
Täuber
Martin G
MG
D042462:4-Quinolones; D000818:Animals; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use; D000077723:Cefepime; D002511:Cephalosporins / Q000134:cerebrospinal fluid* / Q000494:pharmacology / Q000627:therapeutic use; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical / Q000379:methods / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D006801:Humans; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000382:microbiology*; D008826:Microbial Sensitivity Tests / Q000706:statistics & numerical data; D010403:Penicillin Resistance / Q000235:genetics*; D011817:Rabbits; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification
D042462:4-Quinolones; D000890:Anti-Infective Agents; D002511:Cephalosporins; D000077723:Cefepime