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[A study on penetration of mezlocillin into the cerebrospinal fluid]
Abstract:
The concentration of antibiotics in cerebrospinal fluid is of great interest in therapeutics, especially for the treatment of the central nervous system. We studied the penetration of mezlocillin (MZPC) in 3 cases with V-P shunt and 7 cases after neurosurgical operation. After intravenous injection of 4 g MZPC in the 3 cases with V-P shunt, a peak concentration (0.26-3.6 micrograms/ml) of MZPC in the cerebrospinal fluid was reached in 2-4 hours. In the 7 cases after neurosurgical operation, cerebrospinal fluid was sampled at 4 hours after the intravenous injection of 4 g MZPC by spinal tap. Concentrations of MZPC in cerebrospinal fluid ranged from 1.1 to 17.5 micrograms/ml. The mean maximum concentration of MZPC was 5.85 micrograms/ml, which exceeded 90% MIC (minimal inhibitory concentration) against S. epidermidis, E. faecalis, H. influenzae. It is concluded MZPC can be useful for the prophylaxis of meningitis.
Insights
Mezlocillin (MZPC) effectively penetrates cerebrospinal fluid after intravenous administration, reaching concentrations above minimal inhibitory levels for common meningitis pathogens. This suggests its utility in preventing meningitis, particularly post-neurosurgery.
Area of Science:
- Pharmacology
- Infectious Disease
- Neurosurgery
Context:
- Antibiotic penetration into cerebrospinal fluid (CSF) is critical for treating central nervous system infections.
- Understanding drug concentrations in CSF guides therapeutic strategies for neurological conditions.
Purpose:
- To evaluate the penetration and concentration of mezlocillin (MZPC) in CSF.
- To assess MZPC's potential for meningitis prophylaxis in neurosurgical patients.
Summary:
- Mezlocillin (MZPC) was administered intravenously (4g) to patients with V-P shunts and post-neurosurgery.
- CSF concentrations of MZPC were measured, revealing peak levels between 0.26-3.6 µg/ml in V-P shunt cases and 1.1-17.5 µg/ml in post-neurosurgical cases.
- Mean CSF MZPC concentrations exceeded 90% of the minimal inhibitory concentration (MIC) against key pathogens like S. epidermidis, E. faecalis, and H. influenzae.
Impact:
- The study indicates that mezlocillin (MZPC) achieves therapeutic concentrations in CSF.
- Mezlocillin demonstrates potential as a prophylactic agent against meningitis, especially in the context of neurosurgery.