Benzylpenicillin meningitis

Benzylpenicillin achieves peak CSF levels that are reliable for treating sensitive strains of Streptococcus pneumoniae and Neisseria meningitidis but not Haemophilus influenzae and therefore cefotaxime or ceftriaxone are more reliable for suspected H. influenzae meningitis. 

Knowledge of the likely pathogens (and their current local susceptibility rates to antimicrobials) in the clinical situation. Thus cephalexin may be a reasonable first choice for lower urinary tract infection (coliform organisms — depending on the prevalence of resistance locally), and benzylpenicillin for meningitis in the adult (meningococcal or pneumococcal). 

When chlortetracycUne originally became available it was tested as a potential treatment for meningitis. In patients with pneumococcal meningitis it was shown that benzylpenicillin one million units, intramuscularly every 2 hours was more effective than the same regimen of penicillin with chlortetracycUne 500 mg intravenously every 6 hours. Out of 43 patients given penieillin alone, 70% recovered, compared with only 20% in another group of 14 essentially similar patients v o had received both antibacterials. ... 

Another report about the treatment of pneumococcal meningitis with intramuscular or intravenous penicillin and intravenous tetracyclines (chlo-rtetracycline, oxytetracycUne, tetracycline) confirmed that the mortality was much lower in those given only penicillin, rather than the combination of penicillin and a tetracycline. fri the treatment of scarlet fever (Group A beta-haemolytic streptococci), no difference was seen in the initial response to treatment with penicillin (oral procaine benzylpenicillin) and chlortetracycUne or the penicillin alone, but spontaneous re-in-feetion occurred more frequently in those who had received both antibacterials. ... 

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