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[The role of meropenem in bacterial meningitis]

P Fernández Viladrich1

  • 1Servicio de Enfermedades Infecciosas, Hospital de Bellvitge, Barcelona.

Enfermedades Infecciosas Y Microbiologia Clinica
|December 31, 1997
PubMed

Insights

Meropenem offers a safe and effective alternative for bacterial meningitis treatment, particularly for infections caused by multidrug-resistant Gram-negative bacilli. Its high-dose administration and lack of proconvulsive effects make it a valuable option.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Neuroscience

Background:

  • Meropenem is a carbapenem antibiotic with a spectrum similar to imipenem.
  • Unlike imipenem, meropenem can be administered at higher doses and has no demonstrated proconvulsive effect.
  • These properties suggest potential applicability in treating bacterial meningitis.

Purpose of the Study:

  • To review clinical and experimental experience with meropenem in bacterial meningitis treatment.
  • To evaluate the efficacy and safety of meropenem compared to other antibiotics.
  • To identify optimal indications for meropenem in central nervous system infections.

Main Methods:

  • Review of clinical and experimental data on meropenem use in meningitis.
  • Comparison of meropenem's efficacy and safety against cefotaxime and ceftriaxone.
  • Analysis of meropenem's activity against various bacterial meningitis pathogens.

Main Results:

  • Meropenem shows comparable efficacy and safety to cefotaxime/ceftriaxone for meningitis caused by N. meningitidis, H. influenzae, and penicillin-sensitive pneumococci.
  • Limited data exist for penicillin-resistant pneumococcal meningitis, suggesting caution despite similar activity.
  • Meropenem is a primary option for nosocomial meningitis due to multidrug-resistant Gram-negative bacilli (Klebsiella-Serratia-Enterobacter, Acinetobacter).
  • Meropenem may be effective for Pseudomonas aeruginosa meningitis when other treatments fail.

Conclusions:

  • Meropenem is a viable treatment for bacterial meningitis, especially in pediatric and adult populations.
  • Its main indication in CNS infections is nosocomial meningitis caused by multidrug-resistant Gram-negative bacilli.
  • Meropenem shows promise for difficult-to-treat meningitis, including Pseudomonas aeruginosa infections.

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