Meropenem is a new
carbapenem antibiotic of with an antibacterian spectrum similar to that of
imipenem, but from which it may mainly be differentiated by the possibility of its administration at high doses and it has no demonstrated proconvulsive effect, properties which make it applicable in the treatment of
bacterial meningitis. The clinical and experimental experience in the treatment of
bacterial meningitis with this
antibiotic is herein reviewed. It has been observed that the efficacy and safety of
meropenem in
meningitis caused by N. meningitidis, H. influenzae and pneumococci sensitive to
penicillin may be similar to that of
cefotaxime or
ceftriaxone in both the pediatric and adult population. There are very few reports on the treatment of
meningitis caused by pneumococci resistant to
penicillin. However, given that the activity of
meropenem on these pneumococci is similar to that of
cefotaxime and that the doses administered are much lower, it does not appear to be recommendable in the treatment of this indication, although it should be tested in all meningeal strain to these characteristics isolated. It may currently be considered that the main indication of
meropenem in the
infections of the central nervous system is in nosocomial
meningitis by multiresistant gram negative bacilli such as those of the Klebsiella-Serratia-Enterobacter and Acinetobacter sp. group. Therefore a limited, albeit favorable, report on the clinical experience with
meropenem is herein presented.
Meropenem may also be useful in the treatment of
meningitis by Pseudomonas aeruginosa in which other treatments have failed.