Em. Jones et Ap. Macgowan, ANTIMICROBIAL CHEMOTHERAPY OF HUMAN INFECTION DUE TO LISTERIA-MONOCYTOGENES, European journal of clinical microbiology & infectious diseases, 14(3), 1995, pp. 165-175
Listeriosis is an uncommon infection, but when it occurs it carries a
high mortality rate. Early diagnosis is essential and thereafter appro
priate anti microbial chemotherapy. Ampicillin or penicillin plus gent
amicin remains the treatment of choice for most manifestations of list
eriosis, and adequate doses must be given, i.e. greater than 6 g/day o
f ampicillin or penicillin. Co-trimoxazole appears to be an excellent
alternative agent with good penetration into the cerebrospinal fluid.
Vancomycin is an appropriate agent for the treatment of primary bacter
aemia but does not cross the blood-brain barrier sufficiently well to
be useful in meningitis, while erythromycin may be used to treat liste
riosis in cases of pregnancy. Treatment of bacteraemia requires one to
two weeks' therapy, while meningitis cases may need to be treated for
longer; for example, it has been found that most patients with acute
meningitis in the UK were treated for 20 days. Infective endocarditis
needs treatment for six to eight weeks. Doses should be varied with pa
tients' altered organ function and antimicrobial serum monitoring perf
ormed when appropriate.