The treatment of neonatal meningitis due to Gram-negative bacilli with ciprofloxacin: Evidence of satisfactory penetration into the cerebrospinal fluid

Outcome of Treatment of Meningitis Complicated by Ventriculitis due to Multidrug-Resistant <i>Pseudomonas aeruginosa</i> with Ciprofloxacin in an Infant

“…11, 12]. The variation in the CSF concentration is ex plained on the basis of the route of adminis tration of the drug, its half-life and probably the accumulation phenomenon [3,4], Neither the ciprofloxacin levels in the serum nor in the CSF were measured in our patient. Since the strain of P. aeruginosa isolated from CSF consistently exhibited MIC of 0.5 mg/1 for ciprofloxacin, it was expected to have achieved bactericidal concentration in the CSF.…”

“…The published litera ture, which is limited to new quinolones in therapy for bacterial meningitis in humans, shows that the clinical response to these drugs is slow [3,4,6,13], During the 6-week therapy no manifesta tions of toxicity attributable to ciprofloxacin were noted. Since the outcome of treatment of meningitis and ventriculitis due to multidrugresistant P. aeruginosa with ciprofloxacin, as reported in the literature, has been successful, it may be a valuable agent in similar situa tions in pediatric cases [ 13].…”

“…8]. Quinolones have been used infrequently to treat bacterial meningitis in humans [9], Ciprofloxacin has been suc cessfully used for treatment of children with meningitis [2,3] and ventriculitis [4,6]. The mean concentration of ciprofloxacin in the CSF with uninflamed meninges has been re ported to be only 8% of that in the serum [10], However, in the presence of inflammation, concentration of the drug varies from 37 to 175% of the serum level [3, 4.…”

“…The potential of new quinolones to induce arthropathy has been observed in immature animals prompting contraindica tion of their use in pediatric patients. There are several reports indicating promising re sults with the use of ciprofloxacin in life- threatening infections in children [2][3][4][5][6], We recently used ciprofloxacin in an infant to treat meningitis due to a multidrug-resistant Pseudomonas aeruginosa.…”

Vertical transmission of Citrobacter freundii

“…4 Ciprofloxacin has been shown to be effective in Gram negative meningitis, and should be considered in the treatment of this condition. 5 T J Malpas, J J Munoz …”