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Diffusion of ceftriaxone into the cerebrospinal fluid of adults
The Journal of Antimicrobial Chemotherapy
|October 1, 1984
Abstract:
Fourteen adults, three recovering from bacterial meningitis, were given a single 2 g dose of ceftriaxone or three 2 g doses at 12-hourly intervals. The mean per cent penetration of drug into cerebrospinal fluid (CSF) across uninflamed meninges was 1.5%. These levels, although low, are bactericidal in vitro against most pathogens causing meningitis.
Insights
Ceftriaxone penetration into cerebrospinal fluid (CSF) was 1.5% in adults without inflamed meninges. Despite low levels, ceftriaxone demonstrated in vitro bactericidal activity against common meningitis pathogens.
Area of Science:
- Pharmacology
- Infectious Diseases
- Neuroscience
Background:
- Bacterial meningitis requires effective antibiotic treatment.
- Cerebrospinal fluid (CSF) penetration is crucial for antibiotics targeting CNS infections.
- Ceftriaxone is a commonly used antibiotic for bacterial meningitis.
Purpose of the Study:
- To quantify ceftriaxone penetration into CSF in adults.
- To assess the potential efficacy of ceftriaxone against meningitis pathogens based on CSF levels.
Main Methods:
- Fourteen adult participants received either a single 2g dose or three 2g doses of ceftriaxone at 12-hour intervals.
- CSF samples were analyzed to determine ceftriaxone concentration.
- In vitro susceptibility testing was performed against common meningitis pathogens.
Main Results:
- The mean percentage of ceftriaxone penetration into CSF across uninflamed meninges was 1.5%.
- Achieved CSF concentrations were found to be bactericidal in vitro against most common meningitis-causing pathogens.
Conclusions:
- Ceftriaxone exhibits limited penetration into the CSF in the absence of meningeal inflammation.
- Therapeutic concentrations in CSF, though low, are sufficient for in vitro bactericidal activity against key meningitis pathogens.
- Further research may be warranted to optimize dosing or explore adjunctive therapies for meningitis treatment.