Catalán M J, Fernández J M, Vazquez A, Varela de Seijas E, Suárez A, Bernaldo de Quirós J C
Servico de Neurología, Hospital Universitario San Carlos, Madrid, Spain.
Clin Infect Dis. 1994 May;18(5):766-9. doi: 10.1093/clinids/18.5.766.
To our knowledge, we report the first failure of cefotaxime in the treatment of meningitis due to relatively resistant Streptococcus pneumoniae (MICs of penicillin and cefotaxime, 1 microgram/mL). Cure was achieved with a 14-day course of intravenous and intrathecal vancomycin. We recommend that in cases of meningitis caused by strains of S. pneumoniae for which MICs are > or = 1 microgram/mL, cefotaxime should be used with caution; however, if therapeutic failure is suspected therapy should be changed to intravenous and intrathecal vancomycin.
据我们所知，我们报告了首例头孢噻肟治疗相对耐药肺炎链球菌（青霉素和头孢噻肟的最低抑菌浓度均为1微克/毫升）所致脑膜炎失败的病例。通过静脉及鞘内注射万古霉素治疗14天实现了治愈。我们建议，对于肺炎链球菌菌株最低抑菌浓度≥1微克/毫升所致的脑膜炎病例，应谨慎使用头孢噻肟；然而，如果怀疑治疗失败，应改为静脉及鞘内注射万古霉素治疗。
