Inappropriate Antimicrobial Regimen Leading to Recurrent Listeria monocytogenes Meningitis: A PK/PD-Based Case Analysis and a Literature Review
Abstract
Objective: To elucidate the pharmacokinetic/pharmacodynamic (PK/PD) characteristics of antimicrobial agents used in the treatment of Listeria monocytogenes (L. monocytogenes) meningitis and to provide evidence-based guidance for individualized dosing regimens in clinical practice.
Methods: A combined approach involving retrospective case analysis and a literature review was employed. The PK/PD characteristics of various antimicrobial agents applicable to the treatment of L. monocytogenes meningitis were comprehensively evaluated, and the rationality of different dosing regimens was assessed.
Results: Case analysis revealed that inappropriate antimicrobial selection and insufficient dosing contributed to early disease relapse during treatment. Furthermore, a review of 43 published case reports has demonstrated that ampicillin in combination with gentamicin remains the first-line therapy for L. monocytogenes meningitis. However, when penicillin-based agents are contraindicated, alternative antimicrobial agents should be selected according to cerebrospinal fluid (CSF) penetration and PK/PD characteristics, with optimized and standardized dosing regimens established accordingly.
Conclusion: Selection of antimicrobial therapy for L. monocytogenes meningitis should be guided by pharmacokinetic principles. Individualized precision therapy based on lesion-site PK/PD characteristics is essential to improve treatment success and patient prognosis.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Ferulic acid regulates the AKT/GSK-3β/CRMP-2 signaling pathway in a middle cerebral artery occlusion animal model
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
- Photochemical behavior of levofloxacin
- Correlation Between Dissolution Profiles of Salt-Form Drugs in Biorelevant Bicarbonate Buffer and Oral Drug Absorption: Importance of Dose/ Fluid Volume Ratio
- Evaluation of the synergistic potential and mechanisms of action for de novo designed cationic antimicrobial peptides
- Synthesis of [11C]levofloxacin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.