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September 10, 1982

Relapse of Gram-negative Bacillary Meningitis After Cefotaxime Therapy

JAMA. 1982;248(10):1214-1215. doi:10.1001/jama.1982.03330100052031

CONSIDERABLE enthusiasm has developed regarding the treatment of gram-negative bacillary meningitis with newly developed broad-spectrum, third-generation cephalosporin antibiotics.1,2 Compared with other agents such as aminoglycosides or previously available cephalosporins, these antibiotics have remarkable activity against the organisms that cause this life-threatening infection.3 The degree of penetration across the blood-brain barrier is so much greater for third-generation cephalosporins than the previously utilized antibiotics for gram-negative bacillary meningitis that many investigators now suggest that either cefotaxime sodium or moxalactam disodium is the drug of choice for this infection.1 Since the proved therapy of intraventricular aminoglycoside administration may be associated with serious hazards,4 the relative safety of cephalosporins is attractive. The relapse rate, however, has not been determined for this therapy with new cephalosporins. We recently gave one of these agents to a patient with gram-negative bacillary meningitis and observed an adequate initial response followed by relapse of infection.