ANTIBIOTIC-THERAPY FOR ENTEROBACTER MENINGITIS - A RETROSPECTIVE REVIEW OF 13 EPISODES AND REVIEW OF THE LITERATURE

Enterobacter meningitis is an uncommon form of meningitis whose treatm ent poses a therapeutic dilemma because of the development of resistan ce to the third-generation cephalosporins while the patient receives t herapy. In recent years, we have been using trimethoprim-sulfamethoxaz ole (TMP-SMZ) as treatment for this infection. In this report, we revi ewed 13 episodes of enterobacter meningitis that were treated with var ious antibiotic regimens and 33 episodes from the literature. We found that the development of resistance to beta-lactam agents may be much higher than that seen in bacteremias (approximately 30%), that the cas e-fatality rate is lower among our patients than among those described previously, and that all patients who received TMP-SMZ were cured, co mpared with about 70% of those receiving beta-lactam agents. TMP-SMZ a ppears to be an acceptable alternative to the cephalosporins for the t reatment of enterobacter meningitis.