Metronidazole therapy of anaerobic bacteremia, meningitis, and brain abscess

Four patients with Bacteroides fragilis bacteremia, one patient with a brain abscess due to Bacteroides species, Fusobacterium naviforme, and Peptostreptococcus species, and an infant with Bacteroides species ventriculitis and meningitis were treated with metronidazole. In all cases the anaerobic pathogens were eradicated. Five of the six patients recovered. One patient with leukemia in whom B fragilis bacteremia was eradicated by metronidazole treatment subsequently died of Pseudomonas aeruginosa bacteremia. Ventricular fluid and serum concentrations of metronidazole were determined in the case of meningitis and are reported.