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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Why is Benzylpenicillin used for meningococcal meningitis?

I'm a 3rd year medical student, and I just read about meningococcal meningitis, the massive textbook I'm using (which is up to date) said primary treatment should be with benzylpenicillin and if they have an allergy, cefotaxime should be used. I'm wondering why benzylpenicillin is used to terat an infection caused by a gram negative bacteria...? I thought penicillins only had action against gram positive organisms???
Mon, 25 Jan 2016
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General & Family Physician 's  Response
Hi,
Thanks for posting in HCM.
Meningococcal meningitis is a bacterial infection that results in swelling and inflammation of the membranes covering the brain and spinal cord.
Currently, a third-generation cephalosporin (ceftriaxone or cefotaxime) is the drug of choice for the treatment of meningococcal meningitis. Penicillin G, ampicillin, chloramphenicol, fluoroquinolone and aztreonam are alternatives therapies.
Benzylpenicillin (Penicillin G) is narrow spectrum antibiotic used to treat infections caused by susceptible bacteria. Penicillin G is considered the drug of choice for several infections caused by susceptible gram positive aerobic organisms, such as Streptococcus pneumoniae.
No doubt that they have limited activity against gram negative organisms. However, they may be used in some cases to treat infections caused by Neisseria meningitidis (meningococcal meningitis) and Pasteurella.
Also, resistance patterns of the organisms, susceptibility and treatment guidelines vary across regions.
Hope the information provided would be helpful.
Best Wishes.
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