Cefotaxime and ceftriaxone cerebrospinal fluid levels during treatment of bacterial meningitis in children

被引:22
作者
Goldwater, PN [1 ]
机构
[1] Univ Adelaide, Womens & Childrens Hosp, Children Youth & Womens Hlth Serv, Microbiol & Infect Dis Dept, Adelaide, SA, Australia
[2] Univ Adelaide, Dept Paediat, Adelaide, SA, Australia
关键词
antibiotic levels; cerebrospinal fluid; meningitis; cefotaxime; ceftriaxone;
D O I
10.1016/j.ijantimicag.2005.08.005
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Cefotaxime (CTX) and ceftriaxone (CRO) were compared for cerebrospinal fluid (CSF) penetration and antimicrobial efficacy in cases of bacterial meningitis in children. This was a comparative study of CRO (100 mg/kg once daily) and CTX (50 mg/kg 6 hourly) in the treatment of children with bacterial meningitis. The aetiological agents included Streptococcus pneumoniae (SPn), Haemophilus influenzae type b (Hib) and Neisseria meningitidis (NMen). Minimum inhibitory concentrations (MICs) were measured. In 33 patients from whom a second CSF specimen was obtained, CSF was cultured and assayed for antibiotic concentration. Median MICs of CTX and CRO for SPn, Hib and NMen were 0.01 and 0.01 mu g/mL, 0.004 and 0.002 mu g/mL and 0.008 and 0.004 mu g/mL, respectively. All 33 repeat lumbar puncture specimens were sterile. The lowest CSF level recorded (0.45 mu g/mL for CTX) was 45 times the MIC (0.01 mu g/mL). The highest levels (24-35 mu g/mL for CRO) were up to 8750 times the MIC of the patient's causative organism. A wide range of CSF levels for both antibiotics was observed. Levels varied with post-dose interval and duration of illness. On the basis of these findings, clinicians should be reassured that repeat lumbar puncture is not recommended for the causative organisms in this study (i.e., for Hib, NMen and penicillin/cefotaxime/ceftriaxone fully-susceptible SPn). (C) 2005 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
引用
收藏
页码:408 / 411
页数:4
相关论文
共 10 条
[1]   CONCENTRATIONS OF CEFTRIAXONE IN CEREBROSPINAL-FLUID OF CHILDREN WITH MENINGITIS RECEIVING DEXAMETHASONE THERAPY [J].
GAILLARD, JL ;
ABADIE, V ;
CHERON, G ;
LACAILLE, F ;
MAHUT, B ;
SILLY, C ;
MATHA, V ;
COUSTERE, C ;
LOKIEC, F .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1994, 38 (05) :1209-1210
[2]   PNEUMOCOCCAL CARRIAGE AMONGST AUSTRALIAN ABORIGINES IN ALICE-SPRINGS, NORTHERN-TERRITORY [J].
HANSMAN, D ;
MORRIS, S ;
GREGORY, M ;
MCDONALD, B .
JOURNAL OF HYGIENE, 1985, 95 (03) :677-684
[3]  
Hattori Tatsuaki, 1996, Japanese Journal of Antibiotics, V49, P813
[4]  
Jones RN, 1985, MANUAL CLIN MICROBIO, P972
[5]   CEFOTAXIME THERAPY - EVALUATION OF ITS EFFECT ON BACTERIAL-MENINGITIS, CSF DRUG LEVELS, AND BACTERICIDAL ACTIVITY [J].
MULLANEY, DT ;
JOHN, JF .
ARCHIVES OF INTERNAL MEDICINE, 1983, 143 (09) :1705-1708
[6]  
National Committee for Clinical Laboratory Standards, 1990, M2A4 NCCLS
[7]   THE BENEFICIAL-EFFECTS OF EARLY DEXAMETHASONE ADMINISTRATION IN INFANTS AND CHILDREN WITH BACTERIAL-MENINGITIS [J].
ODIO, CM ;
FAINGEZICHT, I ;
PARIS, M ;
NASSAR, M ;
BALTODANO, A ;
ROGERS, J ;
SAEZLLORENS, X ;
OLSEN, KD ;
MCCRACKEN, GH .
NEW ENGLAND JOURNAL OF MEDICINE, 1991, 324 (22) :1525-1531
[8]   PHARMACOKINETICS AND BACTERIOLOGIC EFFICACY OF MOXALACTAM, CEFOTAXIME, CEFOPERAZONE, AND ROCEPHIN IN EXPERIMENTAL BACTERIAL-MENINGITIS [J].
SCHAAD, UB ;
MCCRACKEN, GH ;
LOOCK, CA ;
THOMAS, ML .
JOURNAL OF INFECTIOUS DISEASES, 1981, 143 (02) :156-163
[9]   Prospective comparison of ceftriaxone and cefotaxime for the short-term treatment of bacterial meningitis in children [J].
Scholz, H ;
Hofmann, T ;
Noack, R ;
Edwards, DJ ;
Stoeckel, K .
CHEMOTHERAPY, 1998, 44 (02) :142-147
[10]   MICROBIOASSAY OF ANTIMICROBIAL AGENTS [J].
SIMON, HJ ;
YIN, EJ .
APPLIED MICROBIOLOGY, 1970, 19 (04) :573-&