Intrathecal gentamicin for refractory gram-positive meningitis

Area of Science:

• Infectious Diseases
• Neurology
• Pharmacology

Background:

• Meningitis caused by Staphylococcus aureus and Listeria monocytogenes is associated with significant mortality.
• Standard antibiotic regimens for these infections can be refractory, posing treatment challenges.

Observation:

• Two patients with refractory meningitis were treated: one with Staphylococcus aureus and one with Listeria monocytogenes.
• The staphylococcal meningitis case was refractory to methicillin and oxacillin sodium.
• The Listeria meningitis case was refractory to penicillin G potassium and ampicillin sodium.

Findings:

• Both patients achieved a cure after the addition of intrathecal gentamicin sulfate to their existing treatment regimens.
• Intrathecal gentamicin sulfate demonstrated efficacy in treating severe, antibiotic-resistant meningitis.

Implications:

• The combination of intrathecal gentamicin and a penicillin antibiotic may represent a beneficial therapeutic strategy for refractory staphylococcal or Listeria meningitis.
• This approach could improve outcomes for patients with severe, difficult-to-treat meningitis.
• Further investigation into intrathecal gentamicin for resistant meningitis is warranted.