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Case Commentary: Delayed Cerebral Vasculitis Associated with the Development of Ceftriaxone-Resistant Pneumococcal

Rodrigo Hasbun1

  • 1Department of Medicine, Division of Infectious Diseases, McGovern Medical School UT Health, Houston, Texas, USA rodrigo.hasbun@uth.tmc.edu.

Antimicrobial Agents and Chemotherapy
|January 8, 2020
PubMed

Insights

Drug resistance in Streptococcus pneumoniae meningitis emerged during ceftriaxone treatment due to low drug concentration. Following treatment guidelines could prevent such resistant strains and negative outcomes.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Meningitis caused by Streptococcus pneumoniae is a serious infection.
  • Ceftriaxone is a common antibiotic used for treating bacterial meningitis.
  • Therapeutic drug monitoring is crucial for effective antibiotic treatment.

Observation:

  • A case of Streptococcus pneumoniae meningitis was treated with ceftriaxone monotherapy.
  • Low bactericidal concentrations of ceftriaxone were observed in the cerebrospinal fluid.
  • Emergence of drug resistance in Streptococcus pneumoniae during treatment was documented.

Findings:

  • The study describes the development of ceftriaxone resistance in Streptococcus pneumoniae during therapy.
  • Low drug concentration in cerebrospinal fluid was associated with treatment failure and resistance.
  • The resistant isolate led to an adverse outcome in the patient.

Implications:

  • This case highlights the importance of maintaining adequate antibiotic concentrations at the infection site.
  • Adherence to international guidelines for antibiotic therapy may prevent the emergence of drug resistance.
  • The findings underscore the need for careful patient monitoring and potential dose adjustments in meningitis treatment.
Keywords:
meningitis

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