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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Information on 62 bacteriologically confirmed cases of bacterial meningitis treated with cefotaxime in this country was obtained retrospectively from infectious disease consultants. This series of cases differed markedly from the world cumulative case data thus far presented. One of the two most common organisms treated was the pneumococcus (allergy to penicillin or misdiagnosis of the Gram stain results were the major reasons given). The other organism was Klebsiella. Unanticipated bacteriologic successes were noted in two cases of staphylococcal meningitis secondary to parameningeal foci. The bacteriologic cure rate and survival rate were about 85 percent. Failure of monotherapy was seen in one case of Pseudomonas meningitis, as well as in three of five cases of Enterobacter meningitis. In addition, two cases of Escherichia coli meningitis in which moxalactam therapy inexplicably failed were cured with cefotaxime. Close analysis of killing kinetics appeared to explain the Enterobacter and E. coli failures. Thus, overall not all gram-negative species and not all isolates of any particular species that cause meningitis can be successfully treated by cephalosporins. Data obtained during the investigative trials do not appear to be entirely predicative of what occurred during the free clinical use of an antibiotic. Post-investigatory follow-up and surveillance of all newly introduced therapeutic agents are needed.
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PMID:Experience with the use of cefotaxime in the treatment of bacterial meningitis. 351 59

Experience with the use of first-generation cephalosporins in bacterial meningitis has been disappointing; low concentrations were obtained in the cerebrospinal fluid, and therapeutic failures were encountered. Of the second-generation cephalosporins cefamandole, cefuroxime, and cefoxitin, only cefuroxime has proved efficacy in meningitis caused by meningococci, pneumococci, or Hemophilus influenzae. The third-generation cephalosporins offer new advantages in the treatment of meningitis because they are active at the cerebrospinal fluid concentrations obtainable. Cefotaxime has produced high cure rates in patients with meningitis caused by meningococci, pneumococci, or H. influenzae. Several controlled comparative studies indicate that ceftriaxone is as effective as conventional treatment in therapy for neonatal or childhood meningitis caused by Streptococcus agalactiae, Escherichia coli, or H. influenzae. Moxalactam has been found in uncontrolled studies to be effective when the cause was enteric gram-negative bacilli. Ceftazidime is a new cephalosporin with a high degree of beta-lactamase stability and a broad antibacterial spectrum, which includes Pseudomonas aeruginosa that enters the cerebrospinal fluid. Data from 29 patients who received ceftazidime as monotherapy for bacterial meningitis showed an overall cure or improvement rate of 75.9 percent. Therapy failed in three patients with meningitis caused by gram-positive organisms (Staphylococcus aureus, S. epidermidis, S. agalactiae), and in three with gram-negative organisms. Of 14 patients with Pseudomonas meningitis, 11 showed a cure, as did six of six patients with meningitis caused by Enterobacter, Serratia, or Acinetobacter. More, preferably controlled, studies of the efficacy of ceftazidime in the treatment of meningitis should be undertaken.
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PMID:Role of cephalosporins in the treatment of bacterial meningitis in adults. Overview with special emphasis on ceftazidime. 389 19

The therapeutic efficacy and attainable cerebrospinal fluid (CSF) concentrations of moxalactam, administered by intravenous drip in a dose of 2 g every 4 to 8 h, were evaluated in seven adult patients with bacterial meningitis. Streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter calcoaceticus var. anitratus, each caused infection in four patients, whereas Escherichia coli was the cause of infection in the other three patients. The mean moxalactam concentration in CSF was 14.7 mug/ml (range, 4.7 to 38 mug/ml) in the lumbar samples and 12.1 mug/ml (range, 4.4 to 27 mug/ml) in the ventricular samples. Depending on the time after antibiotic administration, the ratio of CSF to serum concentrations varied from 6.6 to 160%. Satisfactory improvement and negative CSF cultures were initially noted in all seven patients. Six patients were ultimately cured, and the death of the patient with Pseudomonas meningitis could not be clearly attributed to uncontrolled infection.
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PMID:Moxalactam therapy of bacterial meningitis in adults. 622 Jun 73