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Parenteral trimethoprim/sulfamethoxazole for gram-negative bacillary meningitis
Abstract:
Three adults with gram-negative bacillary meningitis were treated with an intravenous preparation of trimethoprim and sulfamethoxazole. This therapy sterilized the cerebrospinal fluid in each case. The infections occurred as complications of neurosurgery, trauma and chronic otitis media. Serratia marcescens was the causative organism in two patients and Proteus vulgaris in the third. The infecting organism was eradicated within three to 17 days of beginning intravenous trimethoprim/sulfamethoxazole. Followup CSF cultures after completing therapy were sterile. These cases suggest intravenous trimethoprim/sulfamethoxazole may be effective treatment for some cases of gram negative bacillary meningitis.
Insights
Intravenous trimethoprim/sulfamethoxazole effectively treated gram-negative bacillary meningitis in three adults, sterilizing cerebrospinal fluid. This antibiotic combination shows promise for managing serious central nervous system infections.
Area of Science:
- Infectious Diseases
- Neuroscience
- Pharmacology
Background:
- Gram-negative bacillary meningitis is a severe central nervous system infection.
- Treatment options for gram-negative meningitis can be limited, especially in post-neurosurgical or trauma cases.
- Trimethoprim/sulfamethoxazole is a combination antibiotic with broad-spectrum activity.
Observation:
- Three adult patients with gram-negative bacillary meningitis were treated with intravenous trimethoprim/sulfamethoxazole.
- Infections arose as complications of neurosurgery, trauma, and chronic otitis media.
- Causative organisms included Serratia marcescens and Proteus vulgaris.
Findings:
- Intravenous trimethoprim/sulfamethoxazole therapy sterilized cerebrospinal fluid in all three patients.
- The infecting organisms were eradicated within 3 to 17 days.
- Follow-up cerebrospinal fluid cultures were sterile after treatment completion.
Implications:
- Intravenous trimethoprim/sulfamethoxazole may be an effective treatment for specific cases of gram-negative bacillary meningitis.
- This regimen could be a valuable option for meningitis complicating neurosurgery, trauma, or otitis media.
- Further clinical studies are warranted to confirm the efficacy and safety of this treatment approach.