B N Kim1, J H Woo, Y S Kim, J Ryu, M N Kim, C H Pai. 1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. griuni@chollian.net
Abstract
BACKGROUND: Resistance of Streptococcus pneumoniae to penicillin is now widespread and rapidly increasing all over the world. This has led to the critical need for alternative antimicrobial therapy. METHODS: To assess the activities of antimicrobial combinations, including cefotaxime, ceftriaxone, vancomycin and meropenem, time-kill studies were conducted against five strains of penicillin- and cephalosporin-resistant S. pneumoniae at clinically achievable antimicrobial concentrations in cerebrospinal fluid. RESULTS: Combinations of an extended-spectrum cephalosporin with vancomycin were not synergistic. Meropenem had a comparable bactericidal activity to those combinations, and its killing activity was not affected by the addition of cefotaxime, ceftriaxone or vancomycin. CONCLUSIONS: It is suggested that meropenem could be an effective alternative for the treatment of penicillin- and cephalosporin-resistant pneumococcal meningitis. However, more clinical data are required before it can be recommended as an effective antimicrobial agent for such cases. Copyright 2000 S. Karger AG, Basel
BACKGROUND: Resistance of Streptococcus pneumoniae to penicillin is now widespread and rapidly increasing all over the world. This has led to the critical need for alternative antimicrobial therapy. METHODS: To assess the activities of antimicrobial combinations, including cefotaxime, ceftriaxone, vancomycin and meropenem, time-kill studies were conducted against five strains of penicillin- and cephalosporin-resistant S. pneumoniae at clinically achievable antimicrobial concentrations in cerebrospinal fluid. RESULTS: Combinations of an extended-spectrum cephalosporin with vancomycin were not synergistic. Meropenem had a comparable bactericidal activity to those combinations, and its killing activity was not affected by the addition of cefotaxime, ceftriaxone or vancomycin. CONCLUSIONS: It is suggested that meropenem could be an effective alternative for the treatment of penicillin- and cephalosporin-resistant pneumococcal meningitis. However, more clinical data are required before it can be recommended as an effective antimicrobial agent for such cases. Copyright 2000 S. Karger AG, Basel