To the Editor.—I read with interest the report of Newlands1 concerning meningitis after stapedectomy.
It is essential that the otologic surgeon be prepared to handle this complication at an early stage to preserve the life of his patient. The use of cephaloridine may not be effective in treating or preventing meningitis, however.
An article in a recent issue of the Medical Letter2 based on a consensus of its infectious disease consultants recommends chloramphenicol as the first-choice antibiotic in penicillinallergic individuals with pneumococcal meningitis and states that cephalosporins are not generally recommended for the treatment of this disease. Likewise, a recent review by Moellering and Swartz' emphasizes the poor penetration of cephalosporins into cerebrospinal fluid, representing one of the greatest drawbacks of this class of antibiotics.
Fisher et al4 found that only 76% of 72 patients with meningitis responded favorably to cephaloridine, despite intrathecal administration in many cases.