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[Studies on cerebrospinal fluid penetration of cefpirome in adult with meningitis]
1Department of Neurosurgery, Ishikawa Prefectural Central Hospital.
Abstract:
A patient with intracerebral hematoma suffered from postoperative bacterial meningitis. Staphylococcus aureus was found from CSF. The organism was multiple drug resistant and refractory to antibiotics including piperacillin (PIPC), cephalexin (CEX), cefotaxime (CTX), ceftazidime (CAZ) and latamoxef (LMOX). It was susceptible to cefpirome (CPR). Treatment with CPR resulted in clinical improvement associated with clearing of the organism from CSF. Serum level of CPR was high enough and CPR penetration into the CSF was satisfactory. The results suggest that CPR is an extremely effective antibiotic for meningitis caused by CPR-susceptible bacteria. Evaluation of the CPR penetration into the CSF of adult meningitis was rarely reported. The result we obtained was important in the treatment for the adult meningitis.
Insights
Cefpirome (CPR) effectively treated bacterial meningitis caused by multidrug-resistant Staphylococcus aureus. This antibiotic demonstrated good penetration into cerebrospinal fluid (CSF), proving crucial for patient recovery.
Area of Science:
- Infectious Diseases
- Neuroscience
- Pharmacology
Background:
- Bacterial meningitis poses a significant threat, especially in patients with complications like intracerebral hematoma.
- Multidrug-resistant Staphylococcus aureus presents a therapeutic challenge, often refractory to standard antibiotic regimens.
- Effective treatment of meningitis requires antibiotics with adequate penetration into the cerebrospinal fluid (CSF).
Observation:
- A patient with intracerebral hematoma developed postoperative bacterial meningitis due to multidrug-resistant Staphylococcus aureus.
- The infecting organism was resistant to piperacillin, cephalexin, cefotaxime, ceftazidime, and latamoxef.
- The bacteria remained susceptible to cefpirome (CPR).
Findings:
- Treatment with cefpirome (CPR) led to clinical improvement and clearance of Staphylococcus aureus from the CSF.
- Therapeutic drug monitoring confirmed adequate serum levels of CPR.
- Satisfactory penetration of CPR into the CSF was observed, supporting its efficacy in treating meningitis.
Implications:
- Cefpirome (CPR) is a highly effective antibiotic for meningitis caused by CPR-susceptible bacteria.
- This case highlights the importance of evaluating antibiotic penetration into the CSF for adult meningitis treatment.
- The findings offer valuable insights for managing complex meningitis cases involving drug-resistant pathogens.