Sipahi, Oğuz ReşatAkyol, DenizÖrmen, BaharÇicek-Şentürk, GönülMermer, SinanÖnal, UğurAmer, Fatma2024-08-252024-08-2520231471-2334https://doi.org/10.1186/s12879-023-08596-zhttps://hdl.handle.net/11454/102838Background Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM).Materials/methods This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018.Results Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p < 0.05). Microbiological success on Day 3-5, end of treatment (EOT) clinical success (80% vs. 54.8%% vs 57.9%), and overall success (EOT success followed by one-month survival without relapse or reinfection 65% vs. 51.6% vs. 45.3%), EOT all cause mortality (ACM) and day 30 ACM (15% vs. 22.6% vs. 26%) did not differ significantly (p > 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34).Conclusions Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.en10.1186/s12879-023-08596-zinfo:eu-repo/semantics/openAccessHealthcare-associated meningitisEmpirical therapyMulticenter studyGlycopeptidesAntibioticsNosocomial Bacterial-MeningitisResistant Staphylococcus-AureusPractice GuidelinesClinical-FeaturesManagementAdultsVentriculitisSeriesArticle231WOS:0010786433000032-s2.0-8517282793937770836Q2Q2