Listeria monocytogenes – Part 4
Treatment of this infection is usually with a high-dose penicillin or ampicillin. Both of these antibiotic groups cross the blood-brain barrier and can be used in treating a CNS Listeria infection. Some clinicians also recommend that an antibiotic in the aminoglycoside family (gentamicin, amikacin, tobramycin) be used in CNS infections, even though these antibiotics do not cross the blood brain barrier (BBB). The rationale is that patients with CNS infections are also probably have sites of Listeria infection in other places in the body.
For patients that have penicillin allergies, Bactrim (trimethoprim-sulfamethoxazole) is sometimes used. It should be noted that antibiotics in the cephalosporin class (cefepime, ceftazidime (Fortaz)) should not be used in attempting to treat Listeria. Because of the intracellular nature of the organism, patients should be treated for a minimum of three weeks.
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