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Breakthrough pneumonia, meningitis and bloodstream infection due to Streptococcus pneumoniae during cefixime therapy

Novella Carannante1, Carlo Pallotto1, Mariano Bernardo2

  • 1First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli , Naples , Italy.

Journal of Chemotherapy (Florence, Italy)
|June 20, 2019
PubMed

Insights

Cefixime may not effectively treat severe invasive pneumococcal infections. Penicillin susceptibility testing and cefixime Minimum Inhibitory Concentration (MIC) are crucial for guiding treatment of Streptococcus pneumoniae infections.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Streptococcus pneumoniae is a primary cause of severe infections like meningitis and pneumonia.
  • Invasive pneumococcal diseases (IPDs) pose significant life-threatening risks.

Observation:

  • Three cases of breakthrough severe IPDs (two meningitis, one bloodstream infection) occurred in patients treated with cefixime.
  • Patients had underlying conditions including otitis, sinusitis, and pneumonia.

Findings:

  • Cefixime demonstrated limited efficacy in treating these invasive pneumococcal infections.
  • Penicillin non-susceptibility in S. pneumoniae may correlate with cefixime treatment failure.
  • Cefixime MIC values above 0.5 mg/L were associated with treatment failure.

Implications:

  • Prompt penicillin susceptibility testing is vital for managing S. pneumoniae infections.
  • Measuring cefixime MIC is recommended to predict treatment outcomes.
  • Clinical guidelines may need updates regarding cefixime use for IPDs.
Keywords:
bloodstream infectioncefiximemeningitispneumonia

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