Managing resistant pneumococcal meningitis in the pediatric patient

S. K. Eades, Stephanie Phelps

Research output: Contribution to journalReview article

Abstract

Penicillin- and extended spectrum cephalosporin-resistant pneumococcal meningitis is becoming more prevalent in many regions of the United States. An increasing number of pneumococcal strains isolated from the cerobrospinal fluid (CSF) of children with bacterial meningitis are defined as highly resistant to penicillin and extended spectrum cephalosporins (MIC > 1 μg/ml and MIC ≤ 2 μg/ml, respectively). For this reason, empiric treatment with a penicillin or cephalosporin alone may no longer be adequate antibiotic coverage for suspected pneumococcal meningitis in the pediatric population. Failure to sterilize the CSF with traditional antibiotic regimens has led some authors to recommend the addition of vancomycin (60 mg/kg/day) to extended spectrum cephalosporins whenever Gram-positive cocci are recovered from the CSF. They suggest continuing combination therapy until the results of susceptibility tests are available. However, due to experience with pneumococcal isolates that developed resistance during cefotaxime therapy, other authors recommend continuing a full course of vancomycin regardless of susceptibility data. New definitions of pneumococcal susceptibility have led to the evaluation of various antibiotic regimens for the treatment of penicillin-and cephalosporin-resistant pneumococcal meningitis.

Original languageEnglish (US)
Pages (from-to)103-110
Number of pages8
JournalJournal of Applied Therapeutics
Volume1
Issue number2
StatePublished - Dec 1 1996

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Pneumococcal Meningitis
Cephalosporins
Pediatrics
Penicillins
Vancomycin
Anti-Bacterial Agents
Gram-Positive Cocci
Bacterial Meningitides
Cefotaxime
Therapeutics
Population

All Science Journal Classification (ASJC) codes

  • Pharmacology

Cite this

Managing resistant pneumococcal meningitis in the pediatric patient. / Eades, S. K.; Phelps, Stephanie.

In: Journal of Applied Therapeutics, Vol. 1, No. 2, 01.12.1996, p. 103-110.

Research output: Contribution to journalReview article

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