Potential role of fluoroquinolones in the treatment of bacterial meningitis

Eur J Clin Microbiol Infect Dis. 1991 Apr;10(4):291-5. doi: 10.1007/BF01967002.

Abstract

The search for new antimicrobial agents in the treatment of bacterial meningitis is justified by a rate of mortality that currently remains unacceptably high and by the emergence of bacterial resistance. Because of their excellent in vitro activity against gram-negative organisms and good penetration into the cerebrospinal fluid, the new fluoroquinolones may have a potential role in the treatment of central nervous system (CNS) infections. Although there are few reports on the use of fluoroquinolones in treatment of patients with CNS infections, experience to date indicates that pefloxacin, the most intensively studied agent, and ciprofloxacin provide effective treatment for patients with meningitis caused by susceptible pathogens. Since they cannot be used in patients whose skeletal growth is incomplete, the place of the fluoroquinolones in the treatment of Haemophilus influenzae meningitis is obviously very limited. Neisseria meningitidis is still exquisitely sensitive to penicillin G and ampicillin, and there is thus no reason to replace these agents by fluoroquinolones, except when patients are allergic to beta-lactam agents, or when parental administration is impossible. A potential use of the new fluoroquinolones would be in the treatment of meningitis due to gram-negative bacilli, including Pseudomonas aeruginosa, and Acinetobacter.

Publication types

  • Review

MeSH terms

  • 4-Quinolones
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents / cerebrospinal fluid
  • Anti-Infective Agents / pharmacokinetics
  • Anti-Infective Agents / therapeutic use*
  • Bacterial Infections / drug therapy*
  • Disease Models, Animal
  • Drug Therapy, Combination
  • Humans
  • Meningitis / drug therapy*

Substances

  • 4-Quinolones
  • Anti-Bacterial Agents
  • Anti-Infective Agents