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High doses of cefotaxime in treatment of adult meningitis due to Streptococcus pneumoniae with decreased susceptibilities to broad-spectrum cephalosporins

1996; American Society for Microbiology; Volume: 40; Issue: 1 Linguagem: Inglês

10.1128/aac.40.1.218

1098-6596

P. F. Viladrich, Carmen Cabellos, Román Pallarés, Fé Tubau, Javier Martínez‐Sanz, Josefina Liñares, F. Gudiol,

Streptococcal Infections and Treatments

We treated nine patients (10 episodes) with meningitis caused by Streptococcus pneumoniae isolates with decreased susceptibilities to broad-spectrum cephalosporins with high doses of cefotaxime (300 mg/kg of body weight per day; maximum dose, 24 g/day). Early adjunctive therapy with dexamethasone was also administered. Cefotaxime MICs were 0.5 (three episodes), 1 (five episodes), and 2 (two episodes) micrograms/ml, and MBCs ranged from 1 to 4 micrograms/ml. Therapy was well tolerated, and all patients experienced prompt clinical improvement. One patient died 8 days after the end of therapy, the central nervous system infection had already been cured, and the remaining patients recovered without relapses.