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Meropenem alone and in combination with vancomycin in experimental meningitis caused by a penicillin-resistant

C M Gerber1, M Cottagnoud, K A Neftel

  • 1Department of Internal Medicine, Inselspital, Berne, Switzerland.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|February 26, 2000
PubMed

Insights

Meropenem demonstrated bactericidal activity against penicillin-resistant pneumococcus meningitis in rabbits, outperforming ceftriaxone and vancomycin. Adding vancomycin to meropenem offered minimal additional benefit.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Bacterial meningitis remains a significant global health concern.
  • Increasing antibiotic resistance, particularly to penicillin, complicates treatment strategies.
  • Rabbit models are crucial for evaluating antimicrobial efficacy in vivo.

Purpose of the Study:

  • To compare the in vivo bactericidal activity of meropenem, ceftriaxone, and vancomycin against penicillin-resistant Streptococcus pneumoniae meningitis.
  • To assess the synergistic effects of combining vancomycin with either ceftriaxone or meropenem.

Main Methods:

  • A rabbit model was established using a penicillin-resistant pneumococcus strain (MIC = 4 microg/ml).
  • Bactericidal activity was quantified by changes in log10 colony-forming units per milliliter per hour (log10 cfu/ml/h).
  • Therapeutic efficacy of monotherapies and combination therapies was evaluated.

Main Results:

  • Meropenem exhibited significant bactericidal activity (-0.48+/-0.14 log10 cfu/ml/h), slightly exceeding ceftriaxone (-0.34+/-0.23 log10 cfu/ml/h) and vancomycin (-0.39+/-0.19 log10 cfu/ml/h).
  • The combination of vancomycin and ceftriaxone showed enhanced activity compared to ceftriaxone alone (-0.55+/-0.19 log10 cfu/ml/h).
  • Adding vancomycin to meropenem resulted in a marginal, statistically insignificant increase in bactericidal effect (-0.55+/-0.28 log10 cfu/ml/h).

Conclusions:

  • Meropenem is a potent bactericidal agent against penicillin-resistant pneumococcal meningitis in this rabbit model.
  • Vancomycin offers limited additional benefit when combined with meropenem for this specific infection.
  • Ceftriaxone combined with vancomycin demonstrates improved efficacy over ceftriaxone monotherapy.

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