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Abstract:
A study has been made of 12 patients with pneumococcal meningitis with ages ranging from 12 months to 59 years. In all cases pneumococcus was isolated in the cerebrospinal fluid (CSF). Seventeen pneumococci were studied for their sensitivity to fosfomycin, ampicillin and gentamicin, including their MIC. All were sensitive to fosfomycin and ampicillin and 7 to gentamicin. On the other hand there has also been made a study of the interaction between fosfomycin plus ampicillin and fosfomycin plus gentamicin. The concentration of antibiotics in plasma and CSF had been determined. The association of fosfomycin to penicillin or ampicillin was also studied in some cases, depending on whether the patient was younger or older than 2 years, and in other cases, the association of fosfomycin with gentamicin. The concentrations of antibiotics in the CSF varied according to the stage of evolution of the meningitis. As regards clinical results, 10 cures and 2 failures have been obtained. The pneumococcus was eradicated from the CSF in all cases, including the two failures, in the control carried out 2-3 days after beginning of treatment, the rest of the analytical data of the CSF became normal within 5 and 17 days treatment.
Insights
This study shows fosfomycin combined with ampicillin or gentamicin is effective against pneumococcal meningitis. Antibiotic treatment eradicated pneumococcus from cerebrospinal fluid in all patients, leading to clinical cures in most cases.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Pneumococcal meningitis remains a significant cause of morbidity and mortality.
- Antibiotic resistance necessitates evaluation of alternative treatment strategies.
Purpose of the Study:
- To evaluate the efficacy and safety of fosfomycin in combination with ampicillin or gentamicin for treating pneumococcal meningitis.
- To determine antibiotic concentrations in plasma and cerebrospinal fluid (CSF).
Main Methods:
- A study involving 12 patients with pneumococcal meningitis.
- In vitro sensitivity testing of pneumococci to fosfomycin, ampicillin, and gentamicin.
- Determination of antibiotic concentrations in plasma and CSF.
- Clinical outcome assessment.
Main Results:
- All 17 pneumococcal isolates were sensitive to fosfomycin and ampicillin; 7 were sensitive to gentamicin.
- Combination therapy with fosfomycin demonstrated eradication of pneumococcus from CSF in all patients.
- Clinical cures were observed in 10 out of 12 patients.
Conclusions:
- Fosfomycin in combination with ampicillin or gentamicin is a viable treatment option for pneumococcal meningitis.
- The combination therapy effectively clears pneumococcus from the CSF, leading to favorable clinical outcomes.