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Linezolid against penicillin-sensitive and -resistant pneumococci in the rabbit meningitis model

P Cottagnoud1, C M Gerber, F Acosta

  • 1Department of Internal Medicine, Inselspital, Freiburgstrasse, 3010 Berne, Switzerland. pcottagn@insel.ch

Insights

Linezolid, an oxazolidinone antibiotic, demonstrated good meningeal penetration in rabbits. However, it showed limited efficacy against pneumococcal strains compared to ceftriaxone and standard regimens.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Microbiology

Background:

  • Linezolid is a novel oxazolidinone antibiotic with activity against Gram-positive bacteria.
  • Bacterial meningitis remains a significant challenge, necessitating effective antibiotic penetration into the cerebrospinal fluid (CSF).

Purpose of the Study:

  • To evaluate the penetration of linezolid into the meninges of rabbits.
  • To assess the in vivo and in vitro efficacy of linezolid against Streptococcus pneumoniae.

Main Methods:

  • Linezolid was administered intravenously to rabbits at 20 mg/kg.
  • CSF and meningeal penetration were measured.
  • Efficacy was tested against penicillin-sensitive and resistant pneumococcal strains in vivo and in vitro.

Main Results:

  • Linezolid achieved good meningeal penetration (38+/-4%) with CSF concentrations ranging from 1.8 to 9.5 mg/L.
  • Linezolid was less effective than ceftriaxone against penicillin-sensitive strains.
  • Against penicillin-resistant strains, linezolid exhibited slightly inferior killing rates compared to ceftriaxone plus vancomycin.
  • In vitro, linezolid was marginally bactericidal at 5x and 10x the minimum inhibitory concentration (MIC).

Conclusions:

  • Linezolid demonstrates adequate penetration into the cerebrospinal fluid and meninges.
  • Its efficacy against Streptococcus pneumoniae, particularly resistant strains, may be limited compared to established therapies.
  • Further investigation into linezolid's role in treating bacterial meningitis is warranted.

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