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Roland Nau, Andreas Wellmer, Adriana Soto, Khristina Koch, Olaf Schneider, Holger Schmidt, Joachim Gerber, Uwe Michel, Wolfgang Brück, Rifampin Reduces Early Mortality in Experimental Streptococcus pneumoniae Meningitis, The Journal of Infectious Diseases, Volume 179, Issue 6, June 1999, Pages 1557–1560, https://doi.org/10.1086/314760
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Abstract
Compared with β-lactam antibiotics, rifampin releases smaller quantities of proinflammatory cell wall products from Streptococcus pneumoniae in vitro. Mice infected intracerebrally with S. pneumoniae were treated subcutaneously with 2-mg doses of rifampin or ceftriaxone (n = 43 each) every 12 h for 3 days and then observed for another 3 days. Rifampin reduced overall mortality from 49% to 26% (P = .04). Kaplan-Meyer analysis revealed a substantial reduction of mortality during the first 24 h in mice receiving rifampin (difference in survival time: P = .007). Eight h after receiving a single 2-mg dose of rifampin or ceftriaxone, rifampintreated mice had lower serum and cerebrospinal fluid concentrations of lipoteichoic and teichoic acids than did ceftriaxone-treated mice (median serum level: < 0.5 vs. 27.0 ng/mL, P = .02; median cerebrospinal fluid level of pooled specimens: 97.5 vs. 206.0 ng/mL). Thus, the use of rifampin appears promising for reducing the release of proinflammatory bacterial components and decreasing early mortality in bacterial meningitis.
