Stratégie thérapeutique des méningites à pneumocoque résistant à la pénicilline en pédiatrie

Abstract

Morbidity and mortality in meningitis remains high in paediatric patients. Streptococcus pneumoniae is actually the first most likely organism to cause meningitis in children 2 months to 2 years old. Data from 1997 show that the rate of penicillin resistance was 53 % in paediatric patients. The increasing prevalence of antibiotic-resistant S. pneumoniae warrants the combination of cefotaxime or ceftriaxone (third generation cephalosporin) plus vancomycin as first-line therapy of presumed pneumococcal meningitis. This regimen should be continued, if the third generation MIC is ≥ 0.5 mg/L. If MIC of cefotaxime or ceftriaxone is < 0.5 mg/L, the third generation can be used alone.