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Published on: February 23, 2014

Treatment of Drug-resistant Pneumococcal Meningitis

Nida Hameed1, Allan R Tunkel

  • 1Department of Medicine, Monmouth Medical Center, 300 Second Avenue, Long Branch, NJ, 07740, USA.

Current Infectious Disease Reports
|February 11, 2011
PubMed

Insights

Penicillin is no longer recommended for pneumococcal meningitis due to resistant strains. Current guidelines suggest vancomycin with a cephalosporin, with other agents considered for difficult cases.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Pneumococcal meningitis treatment has evolved significantly over two decades.
  • Increasing resistance of Streptococcus pneumoniae to penicillin necessitates updated therapeutic strategies.

Purpose of the Study:

  • To outline current recommended empiric and definitive therapies for pneumococcal meningitis.
  • To discuss alternative treatment options for resistant strains and treatment failures.

Main Methods:

  • Review of current clinical guidelines and emerging research on pneumococcal meningitis treatment.
  • Analysis of antibiotic susceptibility patterns and their impact on therapeutic choices.

Main Results:

  • Penicillin is not advised for empiric treatment due to resistance.
  • Vancomycin combined with cefotaxime or ceftriaxone is the recommended empiric regimen.
  • Rifampin may be added for highly resistant strains or delayed responses.
  • Fluoroquinolones like moxifloxacin can be used as salvage therapy with caution.

Conclusions:

  • Current treatment protocols emphasize combination therapy for empiric coverage of pneumococcal meningitis.
  • Management of resistant strains requires careful consideration of susceptibility testing and combination regimens.
  • Further research is needed for newer agents like daptomycin and linezolid.

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