Biomaterial Database

Therapy of penicillin-resistant pneumococcal meningitis. 1995

M T Schwartz, and A R Tunkel

Antimicrobial therapy of pneumococcal meningitis has been altered in recent years based on changes in pneumococcal susceptibility patterns, with emergence of strains that are either relatively or highly resistant to penicillin G (minimal inhibitory concentrations of 0.1-1.0 micrograms/ml and > or = 2 micrograms/ml, respectively. In areas of the world where relatively penicillin-resistant strains of Streptococcus pneumoniae are present, the third generation cephalosporins (either cefotaxime or ceftriaxone) should be used as empiric therapy, and for highly penicillin-resistant pneumococcal strains, vancomycin (with or without rifampin) is recommended. It is imperative that susceptibility testing be performed on all cerebrospinal fluid pneumococcal isolates to guide the choice of antimicrobial therapy. Vaccination recommendations with the 23-valent pneumococcal vaccine should also be strictly enforced for use in appropriate populations that are at increased risk of pneumococcal infections.

UI	MeSH Term	Description	Entries
D008586	Meningitis, Pneumococcal	An acute purulent infection of the meninges and subarachnoid space caused by Streptococcus pneumoniae, most prevalent in children and adults over the age of 60. This illness may be associated with OTITIS MEDIA; MASTOIDITIS; SINUSITIS; RESPIRATORY TRACT INFECTIONS; sickle cell disease (ANEMIA, SICKLE CELL); skull fractures; and other disorders. Clinical manifestations include FEVER; HEADACHE; neck stiffness; and somnolence followed by SEIZURES; focal neurologic deficits (notably DEAFNESS); and COMA. (From Miller et al., Merritt's Textbook of Neurology, 9th ed, p111)	Meningitis, Streptococcus pneumoniae,Experimental Pneumococcal Meningitis,Meningitis, Pneumococcal, Experimental,Meningitis, Pneumococcal, Penicillin-Resistant,Meningitis, Pneumococcal, Recurrent,Experimental Pneumococcal Meningitides,Meningitides, Streptococcus pneumoniae,Meningitis, Experimental Pneumococcal,Pneumococcal Meningitides,Pneumococcal Meningitides, Experimental,Pneumococcal Meningitis,Pneumococcal Meningitis, Experimental,Streptococcus pneumoniae Meningitides,Streptococcus pneumoniae Meningitis
D008826	Microbial Sensitivity Tests	Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses).	Bacterial Sensitivity Tests,Drug Sensitivity Assay, Microbial,Minimum Inhibitory Concentration,Antibacterial Susceptibility Breakpoint Determination,Antibiogram,Antimicrobial Susceptibility Breakpoint Determination,Bacterial Sensitivity Test,Breakpoint Determination, Antibacterial Susceptibility,Breakpoint Determination, Antimicrobial Susceptibility,Fungal Drug Sensitivity Tests,Fungus Drug Sensitivity Tests,Sensitivity Test, Bacterial,Sensitivity Tests, Bacterial,Test, Bacterial Sensitivity,Tests, Bacterial Sensitivity,Viral Drug Sensitivity Tests,Virus Drug Sensitivity Tests,Antibiograms,Concentration, Minimum Inhibitory,Concentrations, Minimum Inhibitory,Inhibitory Concentration, Minimum,Inhibitory Concentrations, Minimum,Microbial Sensitivity Test,Minimum Inhibitory Concentrations,Sensitivity Test, Microbial,Sensitivity Tests, Microbial,Test, Microbial Sensitivity,Tests, Microbial Sensitivity
D010403	Penicillin Resistance	Nonsusceptibility of an organism to the action of penicillins.	Penicillin Resistances,Resistance, Penicillin,Resistances, Penicillin
D002511	Cephalosporins	A group of broad-spectrum antibiotics first isolated from the Mediterranean fungus ACREMONIUM. They contain the beta-lactam moiety thia-azabicyclo-octenecarboxylic acid also called 7-aminocephalosporanic acid.	Antibiotics, Cephalosporin,Cephalosporanic Acid,Cephalosporin,Cephalosporin Antibiotic,Cephalosporanic Acids,Acid, Cephalosporanic,Acids, Cephalosporanic,Antibiotic, Cephalosporin,Cephalosporin Antibiotics
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001428	Bacterial Vaccines	Suspensions of attenuated or killed bacteria administered for the prevention or treatment of infectious bacterial disease.	Bacterial Vaccine,Bacterin,Vaccine, Bacterial,Vaccines, Bacterial
D013296	Streptococcus pneumoniae	A gram-positive organism found in the upper respiratory tract, inflammatory exudates, and various body fluids of normal and/or diseased humans and, rarely, domestic animals.	Diplococcus pneumoniae,Pneumococcus
D014640	Vancomycin	Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to RISTOCETIN that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear.	AB-Vancomycin,Diatracin,VANCO-cell,Vanco Azupharma,Vanco-saar,Vancocin,Vancocin HCl,Vancocine,Vancomicina Abbott,Vancomicina Chiesi,Vancomicina Combino Phar,Vancomicina Norman,Vancomycin Hexal,Vancomycin Hydrochloride,Vancomycin Lilly,Vancomycin Phosphate (1:2),Vancomycin Phosphate (1:2), Decahydrate,Vancomycin Sulfate,Vancomycin-ratiopharm,Vancomycine Dakota,Hydrochloride, Vancomycin,Sulfate, Vancomycin