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Diffusion of cefpirome into the cerebrospinal fluid of patients with purulent meningitis
M Wolff1, P Chavanet, A Kazmierczak
1Clinique de Réanimation des Maladies Infectieuses, Hôpital Bichat-Claude Bernard, Paris, France.
Abstract:
We evaluated the diffusion of cefpirome into the cerebrospinal fluid (CSF) of 25 patients with bacterial meningitis or ventriculitis who were receiving conventional antibiotic treatment. A single cefpirome dose of 2 g was infused at day 2-3 after the onset of therapy. Concentrations of cefpirome in serum and CSF obtained at 2, 4, 8 or 12 h after the infusion were determined by high-performance liquid chromatography. The mean (+/- S.E.M.) concentrations of cefpirome in CSF ranged from 2.26 +/- 1.16 to 4.17 +/- 0.83 mg/L. These concentrations were higher than the MBCs for the pathogens usually responsible for bacterial meningitis.
Insights
Cefpirome effectively penetrates cerebrospinal fluid (CSF) in patients with bacterial meningitis, reaching concentrations above minimum bactericidal levels (MBCs) to combat common pathogens.
Area of Science:
- Pharmacokinetics
- Infectious Diseases
- Neuroscience
Background:
- Bacterial meningitis and ventriculitis are serious central nervous system infections.
- Effective antibiotic penetration into the cerebrospinal fluid (CSF) is crucial for treatment success.
- Cefpirome is a cephalosporin antibiotic with potential utility against meningitis pathogens.
Purpose of the Study:
- To evaluate the diffusion of cefpirome into the CSF of patients with bacterial meningitis or ventriculitis.
- To determine cefpirome concentrations in serum and CSF following a standard therapeutic dose.
- To compare CSF cefpirome concentrations with the minimum bactericidal concentrations (MBCs) of common meningitis-causing bacteria.
Main Methods:
- A single 2g dose of cefpirome was administered intravenously to 25 patients 2-3 days after initiating antibiotic therapy.
- Serum and CSF samples were collected at 2, 4, 8, and 12 hours post-infusion.
- Cefpirome concentrations were quantified using high-performance liquid chromatography (HPLC).
Main Results:
- Mean cefpirome concentrations in CSF ranged from 2.26 +/- 1.16 mg/L to 4.17 +/- 0.83 mg/L across the sampling time points.
- CSF cefpirome levels achieved were consistently higher than the MBCs for typical bacterial meningitis pathogens.
- The study demonstrated significant cefpirome diffusion into the central nervous system.
Conclusions:
- Cefpirome demonstrates favorable penetration into the cerebrospinal fluid in patients with bacterial meningitis and ventriculitis.
- Achieved CSF concentrations suggest cefpirome may be an effective therapeutic option for these serious infections.
- Further clinical studies are warranted to confirm cefpirome's efficacy in treating CNS infections.