Information on 62 bacteriologically confirmed cases of
bacterial meningitis treated with
cefotaxime in this country was obtained retrospectively from
infectious disease consultants. This series of cases differed markedly from the world cumulative case data so far presented. One of the two most common organisms treated was the pneumococcus (
allergy to
penicillin or misdiagnosis of the Gram
stain were the major reasons given). Unanticipated bacteriologic successes were noted in two cases of staphylococcal
meningitis secondary to parameningeal foci. The bacteriologic cure rate and survival rate were about 85%. Failure of monotherapy was seen in one case of pseudomonas
meningitis, as well as in three of five cases of enterobacter
meningitis. In addition, two cases of
Escherichia coli meningitis which had inexplicably failed on
moxalactam were cured with
cefotaxime. Thus, overall not all gram-negative species and not all isolates of any particular species which cause
meningitis can be successfully treated by
cephalosporins. Data obtained during the investigative trials do not appear to be entirely predicative of what occurred during the free clinical use of an
antibiotic. There is a need for the post-investigatory follow-up and surveillance of all newly introduced therapeutic agents.