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Meningitis caused by Streptococcus pneumoniae showing high level resistance to penicillin

K A Wise1, M Bedford, S S Wadhwa

  • 1Wollongong Campus, Illawarra Regional Hospital, Illawarra Area Health Service, New South Wales.

Pathology
|April 1, 1995
PubMed

Insights

A case of meningitis caused by penicillin-resistant Streptococcus pneumoniae (SPn) was treated successfully with high-dose penicillin and ceftriaxone. Empiric treatment for SPn meningitis in Australia should combine high-dose penicillin with a cephalosporin.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Meningitis remains a significant cause of morbidity and mortality worldwide.
  • Emergence of antibiotic resistance in bacterial pathogens poses a critical challenge to effective treatment.
  • Streptococcus pneumoniae is a leading cause of bacterial meningitis.

Observation:

  • A case of meningitis was caused by a Streptococcus pneumoniae strain exhibiting high-level penicillin resistance.
  • The patient's clinical condition improved with a therapeutic regimen involving high-dose penicillin and ceftriaxone.

Findings:

  • The combination therapy of high-dose penicillin and ceftriaxone demonstrated efficacy against the penicillin-resistant Streptococcus pneumoniae strain.
  • Review of Australian and global literature supports this combination approach for empiric treatment.

Implications:

  • Empiric treatment guidelines for Streptococcus pneumoniae meningitis in Australia should be updated.
  • The proposed regimen of high-dose penicillin plus a third-generation cephalosporin offers a viable strategy for managing resistant meningitis.
  • Antimicrobial stewardship and susceptibility testing are crucial for optimizing patient outcomes.

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