Bactericidal activity against intermediately cephalosporin-resistant Streptococcus pneumoniae in cerebrospinal fluid of children with bacterial meningitis treated with high doses of cefotaxime and vancomycin

C Doit; J Barre; R Cohen; S Bonacorsi; A Bourrillon; E H Bingen

doi:10.1128/AAC.41.9.2050

Bactericidal activity against intermediately cephalosporin-resistant Streptococcus pneumoniae in cerebrospinal fluid of children with bacterial meningitis treated with high doses of cefotaxime and vancomycin

Antimicrob Agents Chemother. 1997 Sep;41(9):2050-2. doi: 10.1128/AAC.41.9.2050.

Authors

C Doit¹, J Barre, R Cohen, S Bonacorsi, A Bourrillon, E H Bingen

Affiliation

¹ Service de Microbiologie, Hôpital Robert Debré, Paris, France.

Abstract

Cerebrospinal fluid (CSF) was taken from 19 children with bacterial meningitis treated with cefotaxime (300 mg/kg of body weight/day) and vancomycin (60 mg/kg/day). Median levels of drugs in CSF were smaller than expected, as follows: 4.4 microg/ml for cefotaxime, 3.2 microg/ml for desacetylcefotaxime, and 1.7 microg/ml for vancomycin. The median CSF bactericidal titer against an intermediately cefotaxime-resistant pneumococcus was 1:4. Our data suggest at least an additive interaction between the drugs used in this study.

Publication types

Multicenter Study

MeSH terms

Adolescent
Anti-Bacterial Agents / cerebrospinal fluid*
Anti-Bacterial Agents / therapeutic use*
Cefotaxime / cerebrospinal fluid*
Cefotaxime / therapeutic use*
Cephalosporin Resistance*
Cephalosporins / cerebrospinal fluid*
Cephalosporins / therapeutic use*
Child
Child, Preschool
Dose-Response Relationship, Drug
Drug Therapy, Combination
Humans
Infant
Meningitis, Bacterial / cerebrospinal fluid*
Meningitis, Bacterial / drug therapy*
Microbial Sensitivity Tests
Pneumococcal Infections*
Streptococcus pneumoniae*
Vancomycin / cerebrospinal fluid*
Vancomycin / therapeutic use*

Substances

Anti-Bacterial Agents
Cephalosporins
Vancomycin
Cefotaxime