Review of Pseudomonas aeruginosa meningitis with special emphasis on treatment with ceftazidime.

Pseudomonas aeruginosa meningitis is a rare disease and the optimal antibiotic therapy for this condition is not well established. Results of therapy using various regimens reported since 1960 are reviewed. Ceftazidime, an investigational cephalosporin with potent antipseudomonal activity, has been used to treat P. aeruginosa meningitis in Europe and North America. The results in 24 patients are analyzed here. Most patients had failed to respond to other regimens before commencing therapy with ceftazidime. Nineteen (79.2%) of these patients were cured, and only three (12.5%) were considered therapeutic failures. Hence, ceftazidime is a useful agent in the treatment of gram-negative bacillary meningitis and may be superior to other cephalosporins on the market for the treatment of pseudomonas meningitis. Since development of resistance is a concern, however, it may be prudent to use a concomitant parenteral aminoglycoside with ceftazidime for the first week in the treatment of P. aeruginosa meningitis.