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Cerebrospinal fluid penetration of mezlocillin
Abstract:
The passage of 6-[(R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetamido)-penicillanic acid sodium salt (mezlocillin, Baypen), into the CSF was studied in 9 patients with symptoms of acute meningitis, presumed to be of viral origin. The antibiotic was given as a single 5 g dose i.v. over 30 min. The CSF/serum concentration ratio of mezlocillin showed a variation from 0 to 10.7%. The antibiotic could be effective in the treatment of bacterial meningitis caused by ampicillin-resistant strains of Haemophilus influenzae and by most Enterobacteriaceae, provided these results will be confirmed by a study now in progress. In one patient suffering from meningococcal meningitis this concentration ratio varied between 72% (day 3) and 54% (day 12).
Insights
Mezlocillin (Baypen) passage into cerebrospinal fluid (CSF) was studied in meningitis patients. Results suggest potential efficacy against bacterial meningitis, including ampicillin-resistant strains, warranting further investigation.
Area of Science:
- Pharmacology
- Infectious Diseases
- Neurology
Background:
- Meningitis is a serious infection of the membranes surrounding the brain and spinal cord.
- Understanding antibiotic penetration into the cerebrospinal fluid (CSF) is crucial for effective treatment.
- Mezlocillin is a penicillin-class antibiotic with broad-spectrum activity.
Purpose of the Study:
- To investigate the penetration of mezlocillin into the CSF in patients with acute meningitis.
- To determine the CSF/serum concentration ratio of mezlocillin.
- To evaluate the potential efficacy of mezlocillin against specific bacterial meningitis pathogens.
Main Methods:
- A single intravenous dose of 5 g mezlocillin was administered over 30 minutes to 9 patients with suspected viral meningitis.
- CSF and serum samples were collected to determine drug concentrations.
- CSF/serum concentration ratios were calculated.
Main Results:
- Mezlocillin CSF/serum concentration ratios varied significantly, ranging from 0% to 10.7% in patients with presumed viral meningitis.
- In one patient with meningococcal meningitis, the concentration ratio ranged from 72% on day 3 to 54% on day 12.
- These findings suggest mezlocillin may be effective against ampicillin-resistant Haemophilus influenzae and Enterobacteriaceae.
Conclusions:
- Mezlocillin demonstrates variable penetration into the CSF in patients with acute meningitis.
- The drug shows promise for treating bacterial meningitis, particularly infections caused by ampicillin-resistant strains.
- Further studies are needed to confirm these preliminary findings and establish optimal dosing regimens.