[Successful treatment of beta-lactamase-negative ampicillin-resistant Haemophilus influenzae type b meningitis with high-dose ceftriaxone administration]

Fusayo Sudo, Akira Nakamura, Tadashi Hoshino, Naruhiko Ishiwada, Yoichi Kohno
Kansenshōgaku Zasshi. the Journal of the Japanese Association for Infectious Diseases 2004, 78 (7): 604-8
Haemophilus influenzae type b (Hib) is the most frequent pathogen of bacterial meningitis in Japanese children. The prevalence of beta-lactamase-negative ampicillin-resistant (BLNAR) Hib strain has been increasing in recent years. Furthermore, antibiotic activities of cefotaxime (CTX) and ceftriaxone (CTRX) have decreased against some of those BLNAR strains. We report a case of one-year-old boy who suffered from meningitis caused by BLNAR Hib. The MICs of CTX and CTRX for the strain isolated from cerebrospinal fluid was 1.0 and 0.5 microg/ml, respectively. The patient was administered high-dose CTRX (150 mg/kg/day) and recovered completely without any sequela. The high-dose CTRX administration may be a considerable choice of the treatment of BLNAR meningitis.

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