IS AMOXICILLIN-COTRIMOXAZOLE THE MOST APPROPRIATE ANTIBIOTIC REGIMEN FOR LISTERIA-MENINGOENCEPHALITIS - REVIEW OF 22 CASES AND THE LITERATURE

From June 1983 to January 1994, 22 adult patients with severe Listeria monocytogenes meningoencephalitis were observed in our Intensive Care Unit. Listeria monocytogenes was obtained in culture in cerebrospinal fluid or blood every patient. Seven patients were treated with the co mbination ampicillin-aminoglycoside (group A) and 15 patients with the combination ampicillin (or amoxicillin)-cotrimoxazole (group A + C). Risk factors and gravity scores were similar in both groups. Failure o f the 'gold standard' regimen (group A) was significantly higher (57%) compared to group A + C (6.7%) (P<0.05). Mortality related to L. mono cytogenes was 23.5% in group A compared to 6.7% in group A + C. Morbid ity was reduced in group A + C (13.3%) compared to group A (60%) (P=0. 15). This unique study to demonstrate that amoxicillin-cotrimoxazole s hould be the most appropriate therapeutic regimen for Listeria meningo encephalitis.