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October 15, 1982

Cefotaxime Failure in Group A Streptococcal Meningitis

JAMA. 1982;248(15):1878. doi:10.1001/jama.1982.03330150064028

THE USE of cephalosporins in the therapy for bacterial meningitis has remained controversial, despite almost 20 years of clinical experience with this class of compounds. Cephalothin sodium, a first-generation cephalosporin, was initially reported to be effective in the therapy for staphylococcal and pneumococcal meningitis; however, further study verified the occurrence of meningitis caused by susceptible organisms during cephalothin therapy.1 Similarly, the second-generation cephalosporin, cefamandole sodium, has been a failure in the therapy for highly susceptible strains of Hemophilus influenzae type B that cause meningitis.2

Cefotaxime sodium, a third-generation cephalosporin, has been successfully used in the therapy for meningitis caused by H influenzae, group B streptococcus, meningococcus, and gram-negative rods in children.3 Two adults with Klebsiella pneumoniae meningitis have also been cured by cefotaxime therapy.4 The failure of cefotaxime to prevent or treat meningitis in a patient with group A streptococcal bacteremia is described.

Report of a