Question:medium
A young male presents with meningococcal meningitis and allergy to penicillin. Which is the most suitable drug?
A young male presents with meningococcal meningitis and allergy to penicillin. Which is the most suitable drug?
Show Hint
Need a non-beta-lactam with strong CSF penetration against Neisseria.
Updated On: Jun 24, 2026
- Chloramphenicol
- Meropenem
- Ciprofloxacin
- Teicoplanin
Show Solution
The Correct Option is A
Solution and Explanation
The patient needs an agent that both kills the meningococcus and reaches the cerebrospinal fluid, while sidestepping the penicillin allergy.
The usual choices, penicillin G and ceftriaxone, are off the table or risky: one is the very allergen, the other is a beta-lactam that can cross-react. So look for a non-beta-lactam with proven meningococcal activity and good central nervous system entry. Chloramphenicol fits exactly. It is bactericidal for Neisseria meningitidis, penetrates the inflamed meninges freely, and has long been the recommended substitute when penicillins cannot be used.
The distractors fail for clear reasons. Meropenem still belongs to the beta-lactam family and shares cross-reactivity concerns. Ciprofloxacin's role in this disease is prophylactic eradication of throat carriage, not treatment of active meningitis. Teicoplanin only touches gram-positive bacteria and is useless against a gram-negative diplococcus.
So the safe, effective alternative is the broad-spectrum agent with reliable CSF levels.
\[\boxed{\text{Chloramphenicol}}\]
The usual choices, penicillin G and ceftriaxone, are off the table or risky: one is the very allergen, the other is a beta-lactam that can cross-react. So look for a non-beta-lactam with proven meningococcal activity and good central nervous system entry. Chloramphenicol fits exactly. It is bactericidal for Neisseria meningitidis, penetrates the inflamed meninges freely, and has long been the recommended substitute when penicillins cannot be used.
The distractors fail for clear reasons. Meropenem still belongs to the beta-lactam family and shares cross-reactivity concerns. Ciprofloxacin's role in this disease is prophylactic eradication of throat carriage, not treatment of active meningitis. Teicoplanin only touches gram-positive bacteria and is useless against a gram-negative diplococcus.
So the safe, effective alternative is the broad-spectrum agent with reliable CSF levels.
\[\boxed{\text{Chloramphenicol}}\]
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