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The penetration of amoxicillin into cerebrospinal fluid (CFS) in the presence of meningeal inflammation was evaluated in patients with tuberculous meningitis. Serum and CSF concentrations of amoxicillin were measured at 2 h in nine patients who received a 1-g oral dose and at 1.5 and 4 h in ten patients who received a 2-g intravenous injection of sodium amoxicillin. After the oral dose, CSF concentrations ranged from 0.1 to 1.5 mug/ml. After the intravenous injection, CSF concentrations ranged from 2.9 to 40.0 mug/ml at 1.5 h and from 2.6 to 27.0 mug/ml at 4 h. These data on penetration suggest that parenterally administered sodium amoxicillin may be of value in the therapy of acute bacterial meningitis.

96 patients with meningitis due to Neisseria meningitidis and Diplococcus pneumoniae were treated with epicillin or ampicillin according to a predesigned randomization chart. Results indicate that epicillin and ampicillin are effective single drugs in the treatment of meningococcal and pneumococcal meningitis. No adverse reactions were noted with either drug and they were comparable in their efficacy.

Twelve patients with proven Salmonella typhi or Salmonella paratyphi A bacteriuria and recurrent bacteremia associated with schistosomiasis were treated for four weeks with amoxicillin (250 mg four times daily). Seven of the 12 patients were seriously ill and febrile before treatment. They showed a dramatic response, and, within three to six days of initiation of amoxicillin therapy, they were afebrile and much improved clinically. Amoxicillin was rapidly and highly concentrated in the urine of all patients; peak levels of 115-2,700 mug/ml were obtained within 2-4 hr of the first dose. Concentration of the drug in serum was also rapid and in all but two patients exceeded the minimal inhibitory concentration of the organism within 4 hr of the first dose. Within one week after treatment started, all urine and blood specimens obtained from the patients became negative for Salmonella and remained so throughout the four-week follow-up period, during which the patients were hospitalized.