Appearance of resistance to beta-lactam antibiotics during therapy for Streptococcus pneumoniae meningitis

J Pediatr. 1995 Jul;127(1):98-9. doi: 10.1016/s0022-3476(95)70264-4.


A young boy had meningitis caused by Streptococcus pneumoniae that was relatively resistant to penicillin and susceptible to cefotaxime. After 10 days of therapy with penicillin and cefotaxime, fever recurred and a second lumbar puncture revealed a pneumococcus that was resistant to all beta-lactam antibiotics. We now add vancomycin to empiric third-generation cephalosporin therapy for meningitis in children when gram-positive cocci are seen on the cerebrospinal fluid smear.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Cefuroxime / therapeutic use
  • Cephalosporins / therapeutic use
  • Child
  • Humans
  • Imipenem / therapeutic use
  • Male
  • Meningitis, Pneumococcal / cerebrospinal fluid
  • Meningitis, Pneumococcal / drug therapy
  • Meningitis, Pneumococcal / etiology*
  • Penicillins / therapeutic use
  • Streptococcus pneumoniae / pathogenicity*
  • Vancomycin / therapeutic use
  • beta-Lactam Resistance*


  • Cephalosporins
  • Penicillins
  • Vancomycin
  • Imipenem
  • Cefuroxime