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A pharmacokinetic/pharmacodynamic analysis of ceftaroline prophylaxis in patients with external ventricular drains

Gary E Stein1, Fadi Yasin, Curtis Smith

  • 11 Department of Medicine, Michigan State University , East Lansing, Michigan.

Surgical Infections
|April 1, 2015
PubMed
Abstract

Insights

Ceftaroline shows potential for preventing ventriculostomy-related infections (VRIs) in neurosurgical patients with external ventricular drains (EVDs). Studies indicate its bactericidal activity in both serum and cerebrospinal fluid (CSF).

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Pharmacology

Background:

  • Ceftaroline is a broad-spectrum cephalosporin antibiotic effective against resistant bacteria like MRSA.
  • It may be valuable for preventing and treating ventriculostomy-related infections (VRIs).

Purpose of the Study:

  • To analyze the pharmacokinetics and pharmacodynamics of prophylactic ceftaroline in neurosurgical patients with external ventricular drains (EVDs).

Main Methods:

  • Adult neurocritical care patients with EVDs received prolonged ceftaroline prophylaxis.
  • Serum and cerebrospinal fluid (CSF) samples were collected at 2, 6, and 12 hours post-dose.
  • Concentrations were measured using liquid chromatography-tandem mass spectrometry, and time-kill curves were generated.

Main Results:

  • Mean CSF:serum penetration ratios ranged from 0.5% to 4.3% at collection time points.
  • The mean CSF to serum area under the curve (AUC) ratio was 1.1%.
  • Bactericidal activity was observed against staphylococci in serum and S. pneumoniae in CSF.

Conclusions:

  • Ceftaroline demonstrates potential clinical utility for preventing VRIs in patients with EVDs.
  • Further investigation into ceftaroline's role in VRI prophylaxis is warranted.

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