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Treatment of bacterial meningitis with ceftizoxime
Abstract:
Ceftizoxime was evaluated in the treatment of 18 patients (6 adults and 12 children) with bacterial meningitis. In seven patients Haemophilus influenzae was the causative agent, in three Neisseria meningitidis, in five Streptococcus pneumoniae, and in one each alpha-streptococcus and Escherichia coli; one case was culture negative. Ceftizoxime was administered intravenously in doses of 200 mg/kg per day. Clinical response was appropriate in all patients with a mean time of defervescence of 3.7 days, and sterile cerebrospinal fluid was obtained from all patients at 24 to 36 h after initiation of therapy. The mean concentration of ceftizoxime in 46 cerebrospinal fluid samples obtained during therapy was 8.53 micrograms/ml (range, less than 0.5 to 29.0 micrograms/ml). Ceftizoxime concentrations in cerebrospinal fluid samples were ten- to several hundredfold the bactericidal concentrations of the pathogens isolated from the cerebrospinal fluid. Ceftizoxime penetrates the meninges well during acute infection and appears to be an excellent candidate antibiotic in the treatment of bacterial meningitis.
Insights
Ceftizoxime effectively treated bacterial meningitis in children and adults, clearing infections rapidly. Cerebrospinal fluid concentrations exceeded bactericidal levels, indicating good meningeal penetration.
Area of Science:
- Infectious Diseases
- Pharmacology
- Pediatrics
Background:
- Bacterial meningitis remains a significant cause of morbidity and mortality, necessitating effective antibiotic treatments.
- Ceftizoxime is a third-generation cephalosporin with broad-spectrum activity against common bacterial meningitis pathogens.
- Evaluating ceftizoxime's efficacy and penetration in bacterial meningitis is crucial for optimizing treatment strategies.
Purpose of the Study:
- To assess the clinical effectiveness of ceftizoxime in treating bacterial meningitis in pediatric and adult patients.
- To determine the cerebrospinal fluid (CSF) penetration and concentrations of ceftizoxime during active infection.
- To compare CSF ceftizoxime levels with the in vitro bactericidal concentrations of isolated pathogens.
Main Methods:
- A prospective study involving 18 patients (6 adults, 12 children) diagnosed with bacterial meningitis.
- Intravenous administration of ceftizoxime at a dosage of 200 mg/kg/day.
- Monitoring of clinical response, time to defervescence, CSF sterilization, and CSF drug concentrations.
Main Results:
- All 18 patients showed an appropriate clinical response, with a mean defervescence time of 3.7 days.
- CSF sterilization was achieved in all patients within 24-36 hours of therapy initiation.
- Mean CSF ceftizoxime concentration was 8.53 µg/ml, significantly exceeding the bactericidal concentrations of isolated pathogens (Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, Escherichia coli).
Conclusions:
- Ceftizoxime demonstrates excellent penetration into the cerebrospinal fluid during acute bacterial meningitis.
- The drug achieved concentrations well above the required bactericidal levels for common causative pathogens.
- Ceftizoxime is a highly effective antibiotic candidate for treating bacterial meningitis in both children and adults.