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Randomized comparison of meropenem with cefotaxime for treatment of bacterial meningitis. Meropenem Meningitis Study

K P Klugman1, R Dagan

  • 1Department of Medical Microbiology, University of Witwatersrand, South Africa.

Antimicrobial Agents and Chemotherapy
|May 1, 1995
PubMed

Insights

Meropenem shows promise as an effective treatment for bacterial meningitis, with comparable safety and efficacy to cefotaxime. This carbapenem offers an alternative option for treating meningitis, particularly with rising cephalosporin resistance.

Area of Science:

  • Infectious Diseases
  • Pediatrics
  • Pharmacology

Background:

  • Broad-spectrum cephalosporins are standard treatments for bacterial meningitis.
  • Emerging cephalosporin-resistant pneumococci necessitate alternative antimicrobial agents.
  • Previous carbapenem use (imipenem-cilastatin) was limited by seizure side effects.

Purpose of the Study:

  • To compare the safety and efficacy of meropenem versus cefotaxime in treating pediatric bacterial meningitis.
  • To evaluate meropenem as a potential alternative agent for meningitis treatment.

Main Methods:

  • Prospective randomized trial involving 190 children diagnosed with bacterial meningitis.
  • Patients were assigned to receive either meropenem or cefotaxime.
  • Safety outcomes (seizures, neurological abnormalities) and efficacy (bacterial eradication) were assessed.

Main Results:

  • Seizure incidence before therapy was 16% for meropenem and 7% for cefotaxime.
  • Seizure incidence during therapy was 6% for meropenem and 1% for cefotaxime; none were drug-related.
  • Bacterial eradication was 100% in both treatment groups.

Conclusions:

  • Meropenem demonstrates favorable safety and efficacy in treating bacterial meningitis.
  • Meropenem represents a well-tolerated and effective carbapenem option for meningitis.
  • Further investigation into meropenem's role in meningitis treatment is warranted.

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