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[Metronidazole concentration of the cerebrospinal fluid from slightly inflamed meninges]
Abstract:
The concentrations of metronidazole (Clont i.v.) in the cerebrospinal fluid were measured in 12 patients with viral meningitis or subsiding bacterial meningitis after a single infusion of 500 mg lasting 20 min. 1 h after infusion the CSF-concentrations were between 2,3 micrograms/ml and 7,4 micrograms/ml and 2 h after infusion between 6,5 micrograms/ml and 8,6 micrograms/ml. They attained 45,9% respectively 75,9% of the corresponding serum concentrations. Because the minimal inhibitory concentrations of the most important obligate anaerobic gram-negative bacteria are attained, it appears that metronidazole can be used for the treatment of bacterial meningitis caused by these pathogens.
Insights
Metronidazole effectively penetrates cerebrospinal fluid in patients with meningitis, reaching concentrations sufficient to combat anaerobic gram-negative bacteria. This suggests its potential utility in treating specific bacterial meningitis cases.
Area of Science:
- Pharmacology
- Infectious Diseases
- Neurology
Context:
- Bacterial meningitis remains a critical condition requiring effective antimicrobial penetration into the central nervous system.
- Metronidazole is an antibiotic with activity against anaerobic bacteria, but its efficacy in meningitis requires specific investigation.
Purpose:
- To quantify metronidazole concentrations in cerebrospinal fluid (CSF) following intravenous administration in patients with meningitis.
- To assess the penetration of metronidazole into the CSF relative to serum levels.
- To evaluate the potential of metronidazole for treating bacterial meningitis caused by susceptible anaerobic pathogens.
Summary:
- This study measured metronidazole (Clont i.v.) CSF concentrations in 12 patients with viral or subsiding bacterial meningitis after a 500 mg IV infusion.
- CSF concentrations ranged from 2.3-7.4 µg/mL at 1 hour and 6.5-8.6 µg/mL at 2 hours post-infusion.
- These CSF levels achieved 45.9% and 75.9% of concurrent serum concentrations, respectively, and exceeded minimal inhibitory concentrations for key anaerobic bacteria.
Impact:
- The findings support the use of metronidazole in treating bacterial meningitis caused by specific anaerobic gram-negative bacteria.
- This research contributes to understanding antibiotic pharmacokinetics in the central nervous system for meningitis management.
- Further clinical studies may confirm metronidazole's role in specific meningitis treatment regimens.