Rifampicin+ceftriaxone versus vancomycin+ceftriaxone in the treatment of penicillin- and cephalosporin-resistant pneumococcal meningitis in an experimental rabbit model

Suntur, Bedia Mutay; Yurtseven, Taşkın; Sıpahi, Oğuz Reşat; Büke, Çağrı; Büke, Münir

doi:10.1016/j.ijantimicag.2005.06.010

Cited by 31 publications

(16 citation statements)

References 13 publications

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“…Similar to cephalosporin and carbapenem, the effectiveness of vancomycin is based on the percentage of time in which its concentration in CSF surpasses the minimum bactericide concentration, so the administration intervals are more frequent, form 6 to 12 hours 23 . The recent report of Streptococcus pneumoniae tolerant to vancomycin, there has been a demand to be alert and to make a rational use of this antibiotic 24 . The impact of the introduction of this antibiotic will not replace the early clinical diagnosis of bacterial meningitis at initial stages of inflammatory response, and the time for adopting measures to improve hemodynamic conditions.…”

Section: Resultsmentioning

confidence: 99%

Clinical behavior of Streptococcus pneumoniae meningoencephalitis

Fanego

Dorta‐Contreras

Padilla-Docal

et al. 2009

Arq. Neuro-Psiquiatr.

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-Objective: There was an increased number of cases of meningoencephalitis caused by Streptococcus pneumoniae, after the successful vaccination campaigns against Neisseria meningitidis and Haemophilus influenzae. This paper aims at describing the clinical characteristics, the laboratory findings, the complications, and the therapeutic management of these patients, who have been suffering from this disease since 1993 to 2006. Method: Twelve children with Streptococcus pneumoniae meningoencephalitis admitted to the pediatric hospital of San Miguel del Padron, City of Havana in this period were assessed. Results: Children under one year are the most frequently affected. Septic shock and brain edema were the most severe complications. Three patients died, implying that this disease has a serious course. Early treatment of brain edema is very important to reduce mortality. The elective drugs for treatment of these cases of Streptococcus pneumoniae meningoencephalitis were vancomycin combined with cephalosporin, cefotaxime or ceftriaxone type. Conclusion: Patients with Streptococcus pneumoniae meningoencephalitis show clinical characteristics, complications, and sequels that are different to other bacterial meningoencephalitis, meaning that they could be helpful for physicians considering the differential diagnosis of meningoencephalitis.KEY WORDS: streptococcus pneumoniae, meningoencephalitis, treatment.Comportamiento clinico y terapéutico de la meningoencefalitis por streptococcus pneumoniae resumo -Objetivo: Existe un incremento de la meningoencefalitis producida por Streptococcus pneumoniae, después de las campañas exitosas de vacunación contra Neisseria meningitidis y Haemophilus influenzae. El objetivo de este trabajo es describir las caracteristicas clinicas, los hallazgos de laboratorio, las complicaciones y el manejo terapéutico de los pacientes que sufrieron esta enfermedad desde 1993 a 2006. Método: Se estudiaron doce niños con meningoencefalitis por Streptococcus pneumoniae ingresados en el Hospital Pediátrico de San Miguel del Padrón, Ciudad de La Habana en este periodo. Resultados: Los niños menores de un año son los más frecuentemente afectados. El shock séptico y el edema cerebral las mayores complicaciones. Tres pacientes fallecieron. Esta enfermedad ha tenido un curso serio. El tratamiento temprano del edema cerebral es muy importante para reducir la mortalidad. Los medicamentos de elección para tratar la meningoencefalitis por Strepcococcus pneumoniae en los casos estudiados fueron la vancomicina combinada con cefalosporina del tipo de la cefatoxima o la ceftriaxona. Conclusion: Los pacientes con meningoencefalitis por Streptoccocus pneumoniae exhibieron características clínica, complicaciones y secuelas las cuales se diferencian de otras meningoencefalitis bacterianas. Por eso estos elementos pueden ayudar a los médicos en el diagnóstico diferencial PALAVRAS-CLAVE: streptococcus pneumoniae, meningoencefalitis, tratamiento.

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Section: Resultsmentioning

confidence: 99%

Clinical behavior of Streptococcus pneumoniae meningoencephalitis

Fanego

Dorta‐Contreras

Padilla-Docal

et al. 2009

Arq. Neuro-Psiquiatr.

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“…Rifampin combination therapy has been used for S. pneumoniae infections, especially meningitis caused by penicillin-resistant strains (penicillin-resistant S. pneumoniae [PRSP]) (56,211,236).…”

Section: Other Diseasesmentioning

confidence: 99%

“…The in vitro data for the vancomycin-rifampin combination therapy for treatment of S. pneumoniae infection using time-kill studies again showed indifference, similarly to S. aureus (94). Despite data suggesting that rifampin has poor penetration into the brain, animal studies have had mixed results (56,179,211,236). Using a rabbit model, Nau et al found that rifampin was significantly less active against S. pneumoniae in the CSF than ceftriaxone, with paradoxically less efficacy at higher doses of rifampin (179).…”

Section: Other Diseasesmentioning

confidence: 99%

“…Cormican et al showed in an in vivo study that cephalosporin monotherapy was effective and that the addition of rifampin decreased the bactericidal activity of cefotaxime (56). However, 2 separate in vivo studies of experimental PRSP meningitis comparing ceftriaxone to combination therapy with rifampin found that rifampin combination therapy was highly effective (211,236). The addition of rifampin to meropenem did not improve the clearance of PRSP in a guinea pig model (88).…”

Section: Other Diseasesmentioning

confidence: 99%

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Rifampin Combination Therapy for Nonmycobacterial Infections

2010

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SUMMARY The increasing emergence of antimicrobial-resistant organisms, especially methicillin-resistant Staphylococcus aureus (MRSA), has resulted in the increased use of rifampin combination therapy. The data supporting rifampin combination therapy in nonmycobacterial infections are limited by a lack of significantly controlled clinical studies. Therefore, its current use is based upon in vitro or in vivo data or retrospective case series, all with major limitations. A prominent observation from this review is that rifampin combination therapy appears to have improved treatment outcomes in cases in which there is a low organism burden, such as biofilm infections, but is less effective when effective surgery to obtain source control is not performed. The clinical data support rifampin combination therapy for the treatment of prosthetic joint infections due to methicillin-sensitive S. aureus (MSSA) after extensive debridement and for the treatment of prosthetic heart valve infections due to coagulase-negative staphylococci. Importantly, rifampin-vancomycin combination therapy has not shown any benefit over vancomycin monotherapy against MRSA infections either clinically or experimentally. Rifampin combination therapy with daptomycin, fusidic acid, and linezolid needs further exploration for these severe MRSA infections. Lastly, an assessment of the risk-benefits is needed before the addition of rifampin to other antimicrobials is considered to avoid drug interactions or other drug toxicities.

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“…Reduced susceptibility to penicillin and third-generation cephalosporins of Streptococcus pneumoniae is a growing problem in China although resistance rates vary considerably between countries [2]. Some experts advise that when Streptococcus pneumoniae has been identified and susceptibility testing is pending or not available, empiric treatment should include vancomycin or rifampicin, although there is uncertainty regarding the benefit of adding vancomycin or rifampicin to a third-generation cephalosporin in Streptococcus pneumoniae meningitis patients [39][40][41]. Erythromycin, tetracycline, clindamycin, penicillin and trimethoprim/sulfamethoxazole were the least effective antibiotics against Streptococcus pneumoniae.…”

Section: Discussionmentioning

confidence: 99%

The microbiology and clinical characteristics of bacterial and fungal meningitis in a Chinese hospital

Chen¹,

Hu²,

Liu³

2017

Arch Med Sci Civil Dis

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A b s t r a c t Introduction:The aim was to investigate the distribution, antibiotic resistance, initial clinical and laboratory characteristics of pathogens isolated from the cerebrospinal fluid samples (CSF). Material and methods: The CSF were subjected for identification. The minimum inhibitory concentrations (MICs) of antimicrobial agents were tested. The initial clinical and laboratory characteristics were collected. Results: The rate of positive yield of pathogen meningitis in our study was 8.16% . Among the 1994 non-repetitive pathogens, Gram-positive pathogen was the most common (71.71%), followed by Gram-negative pathogen (20.36%), fungal (6.62%) and Mycobacterium tuberculosis (1.30%). Coagulase-negative staphylococci (CNS) was the most common Gram-positive pathogen and Acinetobacter baumannii (Ab) was the most common Gram-negative pathogen. As to fungal pathogen, Cryptococcus neoformans (CN) was the most common. The main CNS showed higher antimicrobial resistant rate for Penicillin G, oxacillin, clindamycin and erythromycin. Acinetobacter baumannii resistant to the most tested antibiotics and only showed considerable rate of resistance to cefoperazone/sulbactam, tigecycline and amikacin. All CN were susceptible to 5-fluorocytosine and only 3.6% CN were resistance to fluconazole. Long days of hospital stay, fever and meningeal irritation signs were common symptoms in the bacterial and fungal meningitis. Head injury, disturbance of consciousness, the pupil size of both eyes was not equal, pupillary reaction to light was slow or absent were more common in the Ab meningitis. The CSF protein concentration and white blood cells count as well as glucose concentration can be used in guiding initial treatment and further microbiological investigation. Conclusions: The main pathogens showed higher antimicrobial resistant rate and the selection of empiric antibiotics should take into consideration local epidemiology, antibiotic resistance patterns and the suspected causative microorganism.

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Rifampicin+ceftriaxone versus vancomycin+ceftriaxone in the treatment of penicillin- and cephalosporin-resistant pneumococcal meningitis in an experimental rabbit model

Cited by 31 publications

References 13 publications

Clinical behavior of Streptococcus pneumoniae meningoencephalitis

Clinical behavior of Streptococcus pneumoniae meningoencephalitis

Rifampin Combination Therapy for Nonmycobacterial Infections

The microbiology and clinical characteristics of bacterial and fungal meningitis in a Chinese hospital

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