JAC 49/2 pp. 327-330

Before the emergence of penicillin-resistant pneumococci, penicillin was usually the first-line antibiotic in the treatment of pneumococcal infections. The global increase of resistant pneumococci has jeopardized the treatment of pneumococcal infections. Additional resistance to cephalosporins has further limited the treatment options against penicillin-resistant isolates. Furthermore, pneumococcal strains resistant to quinolones have already been isolated. -Lactam antibiotics remain the first-line drugs for pneumococcal diseases, except when penetration into infected tissues is limited, as is the case in meningitis. A combination of vancomycin and a cephalosporin is recommended currently for meningitis due to resistant strains. An alternative regimen based on a monotherapy would represent significant progress, especially when quinolone-resistant strains are suspected. Cefepime is a broad-spectrum fourth-generation cephalosporin with good activity against a variety of human bacterial pathogens, including penicillin-resistant pneumococci, and has good penetration into the cerebrospinal fluid (CSF). The aim of this study was to test the bactericidal activity of cefepime against a pneumococcal strain resistant to penicillin and quinolones in the rabbit meningitis model. The standard regimen consisted of ceftriaxone combined with vancomycin. Materials and methods