Activities of ertapenem, a new long-acting carbapenem, against penicillin-sensitive or -resistant pneumococci in experimental meningitis.
The penetration of ertapenem, a new carbapenem with a long half-life, reached 7.1 and 2.4% into inflamed and noninflamed meninges, respectively. Ertapenem had excellent antibacterial activity in the treatment of experimental meningitis due to penicillin-sensitive and -resistant pneumococci, leading to a decrease of 0.69 +/- 0.17 and 0.59 +/- 0.22 log(10) CFU/ml x h, respectively, in the viable cell counts in the cerebrospinal fluid. The efficacy of ertapenem was comparable to that of standard regimens (ceftriaxone monotherapy against the penicillin-sensitive strain and ceftriaxone combined with vancomycin against the penicillin-resistant strain). In vitro, ertapenem in concentrations above the MIC was highly bactericidal against both strains. Even against a penicillin- and quinolone-resistant mutant, ertapenem had similar bactericidal activity in vitro.
Cottagnoud
P
P
Department of Internal Medicine, Inselspital, Bern, Switzerland. pcottagn@insel.ch
Pfister
M
M
Cottagnoud
M
M
Acosta
F
F
Täuber
M G
MG
D000818:Animals; D000900:Anti-Bacterial Agents / Q000097:blood / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics / Q000494:pharmacology*; D002443:Ceftriaxone / Q000097:blood / Q000493:pharmacokinetics / Q000494:pharmacology; D004195:Disease Models, Animal; D000077727:Ertapenem; D007769:Lactams; D008586:Meningitis, Pneumococcal / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology; D010403:Penicillin Resistance; D011817:Rabbits; D013296:Streptococcus pneumoniae / Q000254:growth & development* / Q000378:metabolism; D014640:Vancomycin / Q000097:blood / Q000493:pharmacokinetics / Q000494:pharmacology; D047090:beta-Lactams
D000900:Anti-Bacterial Agents; D007769:Lactams; D047090:beta-Lactams; D014640:Vancomycin; D002443:Ceftriaxone; D000077727:Ertapenem