Abstract
We used two strains of ampicillin-susceptible Escherichia coli to produce meningitis in rabbits and utilized these models (i) to compare the killing effects of parenteral trimethoprim-sulfamethoxazole (TMP-SMZ) and ampicillin on E. coli in cerebrospinal fluid after 8 h of treatment and (ii) to measure the penetration of TMP-SMZ and ampicillin into cerebrospinal fluid and the brain. At 16 h after intracisternal inoculation with a test strain, rabbits were treated with TMP (6 mg/kg per h) and SMZ (30 mg/kg per h), ampicillin (40 mg/kg per h), or saline intravenously for 8 h. TMP-SMZ levels were measured by high-pressure liquid chromatography, and ampicillin levels were measured by microbiological assay. Mean +/- standard deviation concentrations of TMP, SMZ, and ampicillin in cerebrospinal fluid (mean percent penetration) at the completion of 8 h of therapy were 0.80 +/- 0.41 (18%), 15.7 +/- 21.1 (27.2%), and 2.6 +/- 1.7 (8.9%) microgram/ml, respectively. TMP, SMZ, and ampicillin levels in brain homogenate after 8 h of therapy were 0.23 +/- 0.07 (6.6%), 3.31 +/- 3.3 (5.5%), and 0.6 +/- 4.53 (1.9%) microgram/g, respectively. TMP-SMZ infusion for 8 h produced a significant reduction in mean bacterial counts in cerebrospinal fluid in both models of meningitis compared with saline controls. The decrease in mean bacterial counts with TMP-SMZ therapy was equivalent to that produced by ampicillin.
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- Beam T. R., Jr, Allen J. C. Blood, brain, and cerebrospinal fluid concentrations of several antibiotics in rabbits with intact and inflamed meninges. Antimicrob Agents Chemother. 1977 Dec;12(6):710–716. doi: 10.1128/aac.12.6.710. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beam T. R., Jr, Allen J. C. Comparison of cefamandole, cephalothin, ampicillin, and chloramphenicol in experimental Escherichia coli meningitis. Antimicrob Agents Chemother. 1980 Jan;17(1):37–42. doi: 10.1128/aac.17.1.37. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Farid Z., Girgis N. I., Yassin W. Letter: Trimethoprim-sulfamethoxazole and bacterial meningitis. Ann Intern Med. 1976 Jan;84(1):50–51. doi: 10.7326/0003-4819-84-1-50. [DOI] [PubMed] [Google Scholar]
- Greene B. M., Thomas F. E., Jr, Alford R. H. Letter: Trimethoprim-sulfamethoxazole and brain abscess. Ann Intern Med. 1975 Jun;82(6):812–813. doi: 10.7326/0003-4819-82-6-812. [DOI] [PubMed] [Google Scholar]
- Grose W. E., Bodey G. P., Loo T. L. Clinical pharmacology of intravenously administered trimethoprim-sulfamethoxazole. Antimicrob Agents Chemother. 1979 Mar;15(3):447–451. doi: 10.1128/aac.15.3.447. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kirwan W. O. Cerebrospinal fluid cotrimoxazole levels. J Ir Med Assoc. 1974 Feb 9;67(3):76–77. [PubMed] [Google Scholar]
- Kramer P. W., Griffith R. S., Campbell R. L. Antibiotic penetration of the brain. A comparative study. J Neurosurg. 1969 Sep;31(3):295–302. doi: 10.3171/jns.1969.31.3.0295. [DOI] [PubMed] [Google Scholar]
- Maderazo E. G., Quintiliani R. Treatment of nocardial infection with trimethoprim and sulfamethoxazole. Am J Med. 1974 Oct;57(4):671–675. doi: 10.1016/0002-9343(74)90022-9. [DOI] [PubMed] [Google Scholar]
- McCracken G. H., Jr, Mize S. G., Threlkeld N. Intraventricular gentamicin therapy in gram-negative bacillary meningitis of infancy. Report of the Second Neonatal Meningitis Cooperative Study Group. Lancet. 1980 Apr 12;1(8172):787–791. [PubMed] [Google Scholar]
- McCracken G. H., Jr The rate of bacteriologic response to antimicrobial therapy in neonatal meningitis. Am J Dis Child. 1972 Jun;123(6):547–553. doi: 10.1001/archpedi.1972.02110120071004. [DOI] [PubMed] [Google Scholar]
- Morzaria R. N., Walton I. G., Pickering D. Neonatal meningitis treated with trimethoprim and sulphamethoxazole. Br Med J. 1969 May 24;2(5655):511–512. doi: 10.1136/bmj.2.5655.511-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- PLORDE J. J., GARCIA M., PETERSDORF R. G. STUDIES ON THE PATHOGENESIS OF MENINGITIS. IV. PENICILLIN LEVELS IN THE CEREBROSPINAL FLUID IN EXPERIMENTAL MENINGITIS. J Lab Clin Med. 1964 Dec;64:960–969. [PubMed] [Google Scholar]
- Pelton S. I., Shurin P. A., Klein J. O., Finland M. Quantitative inhibition of Haemophilus influenzae by trimethoprim/sulfamethoxazole. Antimicrob Agents Chemother. 1977 Dec;12(6):649–654. doi: 10.1128/aac.12.6.649. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Perfect J. R., Lang S. D., Durack D. T. Comparison of cotrimoxazole, ampicillin, and chloramphenicol in treatment of experimental Haemophilus influenzae type B meningitis. Antimicrob Agents Chemother. 1980 Jan;17(1):43–48. doi: 10.1128/aac.17.1.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Roy L. P. Sulphamethoxazole-trimethoprim in infancy. Med J Aust. 1971 Jan 16;1(3):148–150. doi: 10.5694/j.1326-5377.1971.tb87481.x. [DOI] [PubMed] [Google Scholar]
- Sabel K. G., Brandberg A. Treatment of meningitis and septicemia in infancy with a sulphamethoxazole/trimethorpim combination. Acta Paediatr Scand. 1975 Jan;64(1):25–32. doi: 10.1111/j.1651-2227.1975.tb04376.x. [DOI] [PubMed] [Google Scholar]
- Sheretz R. J., Dacey R., Sande M. A. Cefamandole in the therapy of experimental pneumococcal meningitis. J Antimicrob Chemother. 1976 Jun;2(2):159–165. doi: 10.1093/jac/2.2.159. [DOI] [PubMed] [Google Scholar]
- Strausbaugh L. J., Mandaleris C. D., Sande M. A. Cefamandole and ampicillin therapy in experimental Haemophilus influenzae meningitis. J Infect Dis. 1977 Feb;135(2):210–216. doi: 10.1093/infdis/135.2.210. [DOI] [PubMed] [Google Scholar]
- Svedhem A., Iwarson S. Cerebrospinal fluid concentrations of trimethoprim during oral and parenteral treatment. J Antimicrob Chemother. 1979 Nov;5(6):717–720. doi: 10.1093/jac/5.6.717. [DOI] [PubMed] [Google Scholar]
- Wilfert C. M. E. coli meningitis: K1 antigen and virulence. Annu Rev Med. 1978;29:129–136. doi: 10.1146/annurev.me.29.020178.001021. [DOI] [PubMed] [Google Scholar]