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[Case of meningitis caused by group B Streptococcus treated with high dose of meropenem]

Yuka Yamagishi1, Hiroshige Mikamo

  • 1Department of Infection Control and Prevention, Aichi Medical University Graduate School of Medicine.

The Japanese Journal of Antibiotics
|November 10, 2011
PubMed

Insights

This case study highlights successful treatment of meningitis caused by group B Streptococcus using high-dose meropenem (6 g/day) combined with linezolid. The combination therapy led to prompt resolution of severe clinical symptoms and laboratory findings.

Area of Science:

  • Infectious Diseases
  • Neuroscience
  • Pharmacology

Background:

  • Bacterial meningitis remains a critical condition requiring effective antimicrobial strategies.
  • Group B Streptococcus (Streptococcus agalactiae) is an increasingly recognized cause of meningitis in adults.
  • Optimal dosing of meropenem for meningitis is still under investigation, despite guideline recommendations.

Observation:

  • A 67-year-old male presented with severe meningitis symptoms, including neurological deficits and cerebrospinal fluid abnormalities.
  • Initial treatment with meropenem (6 g/day) and vancomycin showed inadequate response.
  • Switching vancomycin to linezolid while continuing high-dose meropenem resulted in rapid clinical improvement.

Findings:

  • Cerebrospinal fluid cultures confirmed meningitis due to serotype III group B Streptococcus.
  • High-dose meropenem (6 g/day) in combination with linezolid demonstrated efficacy in treating this GBS meningitis case.
  • Prompt resolution of clinical and laboratory markers of meningitis was observed after treatment modification.

Implications:

  • This case supports the use of high-dose meropenem (6 g/day) for severe bacterial meningitis, particularly when caused by challenging pathogens like GBS.
  • Further pharmacokinetic-pharmacodynamic studies are warranted to establish optimal meropenem dosing regimens for meningitis.
  • Combination therapy with linezolid may be a valuable strategy for refractory GBS meningitis.

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