JACOB J. SCHLESINGER, M.D.; EVERETT B. COOPER, M.D., F.A.C.P.
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To the editor: The recent "Letter" by Farid and associates (Ann Intern Med 84:50-51, 1976) describes the use of trimethoprim-sulfamethoxazole in the treatment of bacterial meningitis. Although cure was effected in each of the cases described, we question the advisability of trimethoprim-sulfamethoxazole as the initial choice of chemotherapy.
Optimal in-vitro synergy between trimethoprim and sulfamethoxazole depends in part on the degree of sensitivity to each component of the drug pair, with relative sensitivity to sulfamethoxazole of particular importance (1, 2). In this regard we wonder whether the Neisseria meningitidis recovered was of serogroup A. These are prevalent in Egypt and
SCHLESINGER JJ, COOPER EB. Treatment of Bacterial Meningitis. Ann Intern Med. ;85:127–128. doi: 10.7326/0003-4819-85-1-127
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Published: Ann Intern Med. 1976;85(1):127-128.
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