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Journal of Antimicrobial Chemotherapy (2000) 45, 63-68
© 2000 The British Society for Antimicrobial Chemotherapy

Evaluation of cefepime alone and in combination with vancomycin against penicillin-resistant pneumococci in the rabbit meningitis model and in vitro

Cynthia M. Gerbera, Marianne Cottagnoudb, Klaus Neftelb, Martin G. Täuberc and Philippe Cottagnouda,*

a Department of Internal Medicine, Inselspital, 3010 Berne; b Department of Internal Medicine, Zieglerspital, 3007 Berne; c Institute of Medical Microbiology, University of Berne, Berne, Switzerland

Cefepime, a broad-spectrum, fourth-generation cephalosporin, showed excellent CSF penetration with levels ranging between 10 and 16 mg/L after two intravenous injections (100 mg/kg). The bactericidal activity of cefepime (–0.60 ± 0.28 {Delta}log10 cfu/mL/h) was superior to that of ceftriaxone (–0.34 ± 0.23 {Delta}log10 cfu/mL/h, P < 0.05) and vancomycin (–0.39 ± 0.19 {Delta}log10 cfu/mL/h, P < 0.05) in the treatment of rabbits with meningitis caused by an isolate highly resistant to penicillin (MIC of penicillin G: 4 mg/L). The addition of vancomycin to both cephalosporins did not significantly increase the killing rate compared with monotherapies (P > 0.05). Similar results were obtained in time–killing experiments in vitro.

* Corresponding author. Tel: +41-31-632-2111; Fax: +41-31-632-3847; E-mail: pcottagn{at}insel.ch


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