Schönwald S, Beus I, Lisić M, Car V, Gmajnicki B
University Hospital of Infectious Disease, Zagreb, Yugoslavia.
Am J Med. 1989 Nov 30;87(5A):248S-249S. doi: 10.1016/0002-9343(89)90071-5.
Gram-negative bacillary meningitis (typically caused by E. coli, K. pneumoniae, P. aeruginosa, A. calcoaceticus, and others) has been associated with head trauma, neurosurgical operations, pathologic anastomosis with nasal cavity, and CSF rhinorrhea, as well as with impaired host defenses. Intravenous ciprofloxacin was given to 20 patients with gram-negative bacillary meningitis. The dose of ciprofloxacin was 200 mg by intravenous infusion, over 30 minutes, every 12 hours for 10 days. Two patients also received intravenous cefotaxime and penicillin G. All patients were monitored daily. Of 20 patients, 18 had cure and therapy failed in two. Because relatively low concentrations of ciprofloxacin are achieved in the CSF, the drug should be used in the treatment of gram-negative bacillary meningitis only if the MICs of the causative pathogen and the ciprofloxacin concentration in CSF can be followed. A randomized, controlled study is needed to compare the efficacy of intravenous ciprofloxacin with standard antibiotic therapy in the treatment of this disease.
革兰阴性杆菌性脑膜炎（通常由大肠杆菌、肺炎克雷伯菌、铜绿假单胞菌、醋酸钙不动杆菌等引起）与头部外伤、神经外科手术、鼻腔病理性吻合、脑脊液鼻漏以及宿主防御功能受损有关。对20例革兰阴性杆菌性脑膜炎患者给予静脉滴注环丙沙星治疗。环丙沙星剂量为200mg，静脉输注30分钟，每12小时1次，共10天。2例患者还接受了静脉注射头孢噻肟和青霉素G。所有患者均每日进行监测。20例患者中，18例治愈，2例治疗失败。由于脑脊液中环丙沙星浓度相对较低，仅当能够监测致病病原体的最低抑菌浓度（MIC）和脑脊液中环丙沙星浓度时，该药才可用于治疗革兰阴性杆菌性脑膜炎。需要进行一项随机对照研究，以比较静脉滴注环丙沙星与标准抗生素疗法治疗该病的疗效。
