CEFTRIAXONE TREATMENT FAILURE OF MENINGITIS DUE TO PENICILLIN AND CEFTRIAXONE RESISTANT STREPTOCOCCUS PNEUMONIA

Third generation cephalosporins (cefotaxime and ceftriaxone in particu lar) are widely used for empirical treatment of bacterial meningitis.( 1,2) However reports from different parts of the world documented occu rrence of meningitis due to Streptococcus pneumonia resistant to third generation cephalosporins with Minimum Inhibitory Concentration equal to or greater than 2 microgram/ml(.2-12) We are reporting a case of m eningitis in the Middle East, caused by Streptococcus pneumonia with i ntermediate resistance to ceftriaxone and penicillin, where combined a nd prolonged course of ceftriaxone (14 days) with penicillin (10 days) failed to clear the cerebrospinal fluid.