Thirteen children with
meningitis due to Haemophilus influenzae, beta-haemolytic streptococcus group B, Streptococcus pneumoniae, Staphylococcus epidermidis, Neisseria meningitidis, Escherichia coli, or Pseudomonas aeruginosa and who had been unsuccessfully treated with other
antibiotics or had causative organisms which were resistant to available
antibiotics were treated with intravenous
cefotaxime. Nine children were cured; in one case
infection (with a different organism) recurred but a further course of
cefotaxime was successful; one child died, with sterile CSF; one child died from his underlying disease (
astrocytoma); and one child was cured with sequelae (
hydrocephalus). A further child with
meningitis caused by E. coli had been treated unsuccessfully by intravenous and intraventricular
chloramphenicol and
gentamicin; intravenous and intraventricular
cefotaxime was successful. The agent was well tolerated. CSF levels were measured in seven children and ranged from 300 to 27 200 microgram/l; published and unpublished in-vitro studies suggest that minimum inhibitory concentrations for
cefotaxime against the organisms commonly causing
bacterial meningitis are usually well below 250 microgram/l.