The mortality for meningitis due to Staphylococcus aureus or Listeria monocytogenes remains high, ranging from 32% to 77%. We treated a patient with staphylococcal meningitis refractory to methicillin sodium and oxacillin sodium, and a patient with Listeria meningitis refractory to penicillin G potassium and ampicillin sodium; both patients were cured when intrathecal gentamicin sulfate was added to the regimen. The combination of intrathecal gentamicin and a penicillin may be beneficial in refractory staphylococcal or Listeria meningitis.
(JAMA 240:469-471, 1978)
Shuman RD, Smith CR. Intrathecal Gentamicin for Refractory Gram-Positive Meningitis. JAMA. 1978;240(5):469-471. doi:10.1001/jama.1978.03290050059024