Treatment of Purulent Meningitis with a New Cephalosporin – Rocephin® (Ro 13–9904)

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Abstract
In 21 of the 24 cases the diagnosis of purulent meningitis was confirmed by culturing the causal agent and/or by immunological diagnosis. The daily dosage of Rocephin ranged between 15-200 mg/kg administered in 2 i.m. injections. A cure was achieved in 2 cases of meningococcal meningitis (1 case with sequelae: blindness in 1 eye), in 5 of 6 cases of Haemophilus influenzae meningitis (1 case with severe neuropsychiatric sequelae), in 3 of 9 cases of pneumococcal meningitis and in 2 of 4 cases of enterobacterial meningitis. The tolerance was generally excellent. Sterilization of the CSF was achieved in all 20 cases of meningitis confirmed by culture. The MIC [minimal inhibitory concentration] levels are lower than the lowest CSF peak for Rocephin found in this study. The unusual pharmacological behavior of Rocephin makes it possible to achieve and to maintain for a long time highly satisfactory concentration levels in the CSF. These properties of Rocephin should lift the long-standing objections to the use of cephalosporins for the treatment of purulent meningitis.

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