Abstract
Using a rabbit model of meningitis, we sought to determine whether concomitant use of dexamethasone affects the penetration and efficacy of ceftriaxone or vancomycin in cerebrospinal fluid. Rabbits were inoculated with a penicillin-sensitive strain of Streptococcus pneumoniae and treated with ceftriaxone or vancomycin with or without dexamethasone. In the ceftriaxone-treated groups, no statistically significant differences were seen between the group treated with dexamethasone and that without dexamethasone; however, in the vancomycin-treated groups we found statistically significant lower cerebrospinal fluid vancomycin levels at 2 h in the dexamethasone-treated rabbits and differences in bacterial killing.
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Selected References
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- Brady M. T., Kaplan S. L., Taber L. H. Association between persistence of pneumococcal meningitis and dexamethasone administration. J Pediatr. 1981 Dec;99(6):924–926. doi: 10.1016/s0022-3476(81)80023-6. [DOI] [PubMed] [Google Scholar]
- Cabellos C., Viladrich P. F., Verdaguer R., Pallares R., Liñares J., Gudiol F. A single daily dose of ceftriaxone for bacterial meningitis in adults: experience with 84 patients and review of the literature. Clin Infect Dis. 1995 May;20(5):1164–1168. doi: 10.1093/clinids/20.5.1164. [DOI] [PubMed] [Google Scholar]
- Dacey R. G., Sande M. A. Effect of probenecid on cerebrospinal fluid concentrations of penicillin and cephalosporin derivatives. Antimicrob Agents Chemother. 1974 Oct;6(4):437–441. doi: 10.1128/aac.6.4.437. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Girgis N. I., Farid Z., Mikhail I. A., Farrag I., Sultan Y., Kilpatrick M. E. Dexamethasone treatment for bacterial meningitis in children and adults. Pediatr Infect Dis J. 1989 Dec;8(12):848–851. doi: 10.1097/00006454-198912000-00004. [DOI] [PubMed] [Google Scholar]
- Jolley M. E., Stroupe S. D., Schwenzer K. S., Wang C. J., Lu-Steffes M., Hill H. D., Popelka S. R., Holen J. T., Kelso D. M. Fluorescence polarization immunoassay. iii. an automated system for therapeutic drug determination. Clin Chem. 1981 Sep;27(9):1575–1579. [PubMed] [Google Scholar]
- Lebel M. H., Freij B. J., Syrogiannopoulos G. A., Chrane D. F., Hoyt M. J., Stewart S. M., Kennard B. D., Olsen K. D., McCracken G. H., Jr Dexamethasone therapy for bacterial meningitis. Results of two double-blind, placebo-controlled trials. N Engl J Med. 1988 Oct 13;319(15):964–971. doi: 10.1056/NEJM198810133191502. [DOI] [PubMed] [Google Scholar]
- Odio C. M., Faingezicht I., Paris M., Nassar M., Baltodano A., Rogers J., Sáez-Llorens X., Olsen K. D., McCracken G. H., Jr The beneficial effects of early dexamethasone administration in infants and children with bacterial meningitis. N Engl J Med. 1991 May 30;324(22):1525–1531. doi: 10.1056/NEJM199105303242201. [DOI] [PubMed] [Google Scholar]
- París M. M., Hickey S. M., Uscher M. I., Shelton S., Olsen K. D., McCracken G. H., Jr Effect of dexamethasone on therapy of experimental penicillin- and cephalosporin-resistant pneumococcal meningitis. Antimicrob Agents Chemother. 1994 Jun;38(6):1320–1324. doi: 10.1128/aac.38.6.1320. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schaad U. B., Lips U., Gnehm H. E., Blumberg A., Heinzer I., Wedgwood J. Dexamethasone therapy for bacterial meningitis in children. Swiss Meningitis Study Group. Lancet. 1993 Aug 21;342(8869):457–461. doi: 10.1016/0140-6736(93)91592-a. [DOI] [PubMed] [Google Scholar]
- Scheld W. M., Brodeur J. P. Effect of methylprednisolone on entry of ampicillin and gentamicin into cerebrospinal fluid in experimental pneumococcal and Escherichia coli meningitis. Antimicrob Agents Chemother. 1983 Jan;23(1):108–112. doi: 10.1128/aac.23.1.108. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Täuber M. G., Sande M. A. Dexamethasone in bacterial meningitis: increasing evidence for a beneficial effect. Pediatr Infect Dis J. 1989 Dec;8(12):842–844. doi: 10.1097/00006454-198912000-00002. [DOI] [PubMed] [Google Scholar]
- Viladrich P. F., Gudiol F., Liñares J., Pallarés R., Sabaté I., Rufí G., Ariza J. Evaluation of vancomycin for therapy of adult pneumococcal meningitis. Antimicrob Agents Chemother. 1991 Dec;35(12):2467–2472. doi: 10.1128/aac.35.12.2467. [DOI] [PMC free article] [PubMed] [Google Scholar]