LIMITED EFFICACY OF PENTOXIFYLLINE AS ANTIINFLAMMATORY AGENT IN EXPERIMENTAL PNEUMOCOCCAL MENINGITIS

Dexamethasone appears to show some adverse side-effects as adjunctive anti-inflammatory agent in bacterial meningitis. For this reason, we t ested the anti-inflammatory and neuroprotective effect of pentoxifylli ne administered 15 min before starting antibiotic treatment with ceftr iaxone (n = 10) versus antibiotic therapy alone (n = 9) in the rabbit model of pneumococcal meningitis. Pentoxifylline lowered the medians o f leucocyte density, tumour necrosis factor-alpha (TNF-alpha) and lact ate in the cerebrospinal fluid (CSF), but only leucocyte migration int o the subarachnoid space was significantly inhibited 8 h after initiat ion of therapy (P = 0.01). CSF protein, brain water content, and the e ntry of ceftriaxone into CSF were not influenced by pentoxifylline. Th e density of neuronal apoptoses in the dentate gyms was slightly lower in animals receiving pentoxifylline than in those treated with ceftri axone only, The median concentration of neuron-specific enolase in CSF was lower in the pentoxifylline-treated group, but the difference was not significant. In conclusion, pentoxifylline showed some anti-infla mmatory activity in pneumococcal meningitis, but the substance failed significantly to reduce neuronal damage.