TY - JOUR
T1 - In vitro antibiotic synergy against Flavobacterium meningosepticum
T2 - Implications for therapeutic options
AU - Di Pentima, M. Cecilia
AU - Mason, Edward
AU - Kaplan, Sheldon
PY - 1998
Y1 - 1998
N2 - Flavobacterium meningosepticum is an unusual, highly resistant, gram- negative bacillus that is associated with neonatal meningitis and nursery outbreaks of meningitis. The optimal therapy for this infection is not known. We successfully treated three neonates with intravenous vancomycin and rifampin. We determined the in vitro activity of meropenem, ciprofloxacin, vancomycin, linezolid (PNU-100766), and rifampin, alone and in combination, against four isolates of F. meningosepticum from neonates with sepsis and meningitis. MICs were determined by tube dilution, and fractional inhibitory concentrations were calculated with use of the checkerboard microtiter dilution technique. Synergy was observed between rifampin and vancomycin against three isolates, while combinations of vancomycin, ciprofloxacin, and linezolid showed an additive effect against all isolates. These results support the clinical evidence that the combination of vancomycin and rifampin is an appropriate regimen for neonatal meningitis due to F. meningosepticum. The combination of meropenem and vancomycin was antagonistic. The clinical efficacy of combinations including ciprofloxacin, newer quinolones, or linezolid for treating F. meningosepticum meningitis deserves further study.
AB - Flavobacterium meningosepticum is an unusual, highly resistant, gram- negative bacillus that is associated with neonatal meningitis and nursery outbreaks of meningitis. The optimal therapy for this infection is not known. We successfully treated three neonates with intravenous vancomycin and rifampin. We determined the in vitro activity of meropenem, ciprofloxacin, vancomycin, linezolid (PNU-100766), and rifampin, alone and in combination, against four isolates of F. meningosepticum from neonates with sepsis and meningitis. MICs were determined by tube dilution, and fractional inhibitory concentrations were calculated with use of the checkerboard microtiter dilution technique. Synergy was observed between rifampin and vancomycin against three isolates, while combinations of vancomycin, ciprofloxacin, and linezolid showed an additive effect against all isolates. These results support the clinical evidence that the combination of vancomycin and rifampin is an appropriate regimen for neonatal meningitis due to F. meningosepticum. The combination of meropenem and vancomycin was antagonistic. The clinical efficacy of combinations including ciprofloxacin, newer quinolones, or linezolid for treating F. meningosepticum meningitis deserves further study.
UR - http://www.scopus.com/inward/record.url?scp=0031949551&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031949551&partnerID=8YFLogxK
U2 - 10.1086/520309
DO - 10.1086/520309
M3 - Article
C2 - 9597247
AN - SCOPUS:0031949551
SN - 1058-4838
VL - 26
SP - 1169
EP - 1176
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 5
ER -