Staphylococcal central nervous system infections treated with cloxacillin.

A retrospective review of 20 patients with staphylococcal central nervous system (CNS) infections treated with cloxacillin is presented. Eleven of these patients had Staphylococcus aureus meningitis secondary to neurosurgery or spontaneously induced. Six patients had ventricular shunt or drainage infection, two secondary to Staph. aureus and five grew Staph. epidermidis (with one mixed infection). Three patients presented with brain abscess, one with mixed anaerobic infection and all grew Staph. aureus. Cure with cloxacillin was achieved in 15 of the 20 patients. Failure of therapy was associated with doses of 6 g or less per day, and cure with doses of 12 g or more per day. Cloxacillin is effective in staphylococcal CNS infections when used in large parenteral doses.