Outcome of 8-hour dosing intervals with beta-lactam antibiotics in adult acute bacterial meningitis.

The outcome of dosing with beta-lactam antibiotics at 8-h intervals for adult patients with community-acquired acute bacterial meningitis was retrospectively analysed at Sahlgrenska University Hospital, Gothenburg, Sweden. 80 medical records were identified for a 6-y period from 1999 to 2004. The most common pathogens noted were Streptococcus pneumoniae (47.5%), Neiseria meningitidis (12.5%), and Listeria monocytogenes (5.0%). Other bacteria were diagnosed in 16.3% of all episodes, but the bacteriological aetiology remained unknown in 18.8%. 79 episodes of bacterial meningitis were treated with beta-lactam antibiotics at 8-h dosing intervals. The mortality rate in these patients was 6.3%, with an incidence of permanent neurological deficiencies of 24.1%. Our study shows that a low mortality rate can be achieved using beta-lactam antibiotics at longer dosing intervals than usually recommended by international guidelines.