Therapeutic Efficacy of Meropenem for Treatment of Experimental Penicillin-Resistant Pneumococcal Meningitis.
10.3346/jkms.2004.19.1.21
- Author:
Shin Woo KIM
1
;
Joung Hwa JIN
;
Soo Jung KANG
;
Sook In JUNG
;
Yeon Sook KIM
;
Choon Kwan KIM
;
Hyuck LEE
;
Won Sup OH
;
Sungmin KIM
;
Kyong Ran PECK
;
Jae Hoon SONG
Author Information
1. Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Meningitis;
Pneumococcal;
Carbapenems;
Penicillin Resistance;
Cephalosporin Resistance
- MeSH:
Animals;
Anti-Bacterial Agents/pharmacology;
Cerebrospinal Fluid;
Disease Models, Animal;
*Drug Resistance, Microbial;
Human;
Male;
Meningitis, Pneumococcal/*drug therapy;
Penicillins/*pharmacology;
Rabbits;
Streptococcus pneumoniae;
Support, Non-U.S. Gov't;
Thienamycins/*pharmacology;
Time Factors
- From:Journal of Korean Medical Science
2004;19(1):21-26
- CountryRepublic of Korea
- Language:English
-
Abstract:
With the widespread emergence of antimicrobial resistance, combination regimens of ceftriaxone and vancomycin (C+V) or ceftriaxone and rifampin (C+R) are recommended for empirical treatment of pneumococcal meningitis. To evaluate the therapeutic efficacy of meropenem (M), we compared various treatment regimens in arabbit model of meningitis caused by penicillin-resistant Streptococcus pneumoniae (PRSP). Therapeutic efficacy was also evaluated by the final bacterial concentration in the cerebrospinal fluid (CSF) at 24 hr. Each group consisted of six rabbits. C+V cleared the CSF at 10 hr, but regrowth was noted in 3 rabbits at 24 hr. Meropenem monotherapy resulted in sterilization at 10 hr, but regrowth was observed in all 6 rabbits at 24 hr. M+V also resulted in sterilization at 10 hr, but regrowth was observed in 2 rabbits at 24 hr. M+V was superior to the meropenem monotherapy at 24 hr (reduction of 4.8 vs. 1.8 log10 cfu/mL, respectively; p=0.003). The therapeutic efficacy of M+V was comparable to that of C+V (reduction of 4.8 vs. 4.0 log10 cfu/mL, respectively; p=0.054). The meropenem monotherapy may not be a suitable choice for PRSP meningitis, while combination of meropenem and vancomycin could be a possible alternative in the treatment of PRSP meningitis.
