Bactericidal and Bacteriostatic Action of Chloramphenicol Against Meningeal Pathogens

Abstract

The bacteriostatic and bactericidal effects of chloramphenicol, ampicillin, tetracycline, and sulfisoxazole were compared against several potential meningeal pathogens. Chloramphenicol is bactericidal at clinically achievable concentrations againstHaemophilus influenzae, Streptococcus pneumoniae, andNeisseria meningitidis. It is bacteriostatic against gram-negative bacilli of the familyEnterobacteriaceaeand againstStaphylococcus aureus. Chloramphenicol has proven highly efficacious in the treatment of bacterial meningitis caused by those organisms against which it is bactericidal at low concentrations. Because leukocytic phagocytosis in the subarachnoid space is inefficient, we propose that bactericidal activity in cerebrospinal fluid is important for optimal therapy of bacterial meningitis. Chloramphenicol does not provide such activity in meningitis caused by enteric gram-negative bacilli.