A SINGLE DAILY DOSE OF CEFTRIAXONE FOR BACTERIAL-MENINGITIS IN ADULTS- EXPERIENCE WITH 84 PATIENTS AND REVIEW OF THE LITERATURE

Although the pharmacokinetics of ceftriaxone allows its administration in a single dairy dose, this practice is not standard in the treatmen t of bacterial meningitis, Herein, we review our experience and that o f other investigators with this mode of therapy, We used a single dair y dose of ceftriaxone (50 mg/[kg . d]; maximum, 4 g/d) for the treatme nt of bacterial meningitis in 84 adult patients, Meningitis was due to Neisseria meningitidis in 34 cases, to Streptococcus pneumoniae in 25 , to Escherichia coli in three, to Klebsiella pneumoniae in two, to Ha emophilus influenzae in two, to viridans streptococci in two, and to a n unknown agent in 16. Eleven patients died, for an overall mortality of 13%; therapy failed in three additional cases. The mean trough leve ls of ceftriaxone in cerebrospinal fluid was 3.5 mu g/mL; the median t rough bactericidal titer at this site was 1:128. Both our experience a nd that in the literature suggest that a single daily dose is optimal when ceftriaxone is used for the treatment of bacterial meningitis.