Gram Positive Cocci
Which of the following is true regarding menin-gitis with Streptococcus pneumoniae?
|A||Cephalosporins are always effective.|
|B||One desires a concentration of antibiotics in the cerebral spinal fluid 10 times the minimal inhibition concentration.|
|C||Penicillin is always effective.|
|D||Resistance is not increasing in Streptococcus pneumoniae.|
a. Because pneumococci are sensitive to many antimicrobial drugs, early treatment usually results in rapid recovery. Antibody response (host's active immunity) seems to play a diminished role today.
b. Penicillin G is the drug of choice, but 5-10 percent of the isolates in the United States are penicillin resistant (MIC Â³ 2 microgram/mL), and 20 percent are moderately resistant (0.1-1 microgram/mL).
c. Resistance to cephalosporins, tetracycline, and erythromycin has been demonstrated, although pneumococci remain susceptible to vancomycin. In reference to penicillin therapy, one rule of thumb is to aim for a concentration of 10 times the MIC in the CSF.