How antibiotics work in cerebrospinal fluid: an important milestone in meningitis research

The study shows that commonly used antibiotics may be less effective in cerebrospinal fluid than laboratory tests suggest, highlighting the need for better and more realistic testing methods to determine the right medication more quickly.

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An international study has provided new insight into how antibiotics work in cerebrospinal fluid in bacterial meningitis. Prof. Dr. Nina van Sorge, Amsterdam UMC, and Dr. George Sakoulas, UC San Diego, USA, successfully completed this research in October 2025, with financial support from ItsME Foundation.

Meningitis is a life threatening disease: despite treatment, 1 in 6 patients still dies and many survivors are left with lasting symptoms. A rapid and accurate choice of antibiotics is therefore crucial, but increasing resistance is making this more difficult. In addition, standard laboratory tests, which examine bacteria in culture media, do not accurately match the conditions in real cerebrospinal fluid. As a result, an antibiotic may appear weak in the laboratory while it works well in the body, or the other way around.

The study shows that commonly used antibiotics, such as ampicillin and cefotaxime, may be less effective in cerebrospinal fluid than laboratory tests suggest. That is why better, more realistic tests are needed. Thanks to this new knowledge, work can now continue on faster and more accurate methods to determine the best medicine for each patient.