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[Cefuzonam penetration into cerebrospinal fluid]

Y Yasumoto1, Y Kadota, K Kumami

  • 1Department of Neurosurgery, Matsumura General Hospital.

The Japanese Journal of Antibiotics
|January 1, 1993
PubMed
Summary

Cefuzonam (CZON) effectively penetrates cerebrospinal fluid (CSF) in neurosurgical patients, with higher concentrations observed in cases of meningeal reaction or severe brain damage. This suggests CZON is suitable for treating CNS infections.

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Area of Science:

  • Pharmacokinetics
  • Infectious Diseases
  • Neurosurgery

Background:

  • Cerebrospinal fluid (CSF) penetration of antibiotics is crucial for treating central nervous system infections.
  • Neurosurgical patients often present complex conditions affecting drug distribution.
  • Understanding cefuzonam (CZON) pharmacokinetics in CSF is vital for optimizing treatment.

Purpose of the Study:

  • To evaluate the penetration of cefuzonam (CZON) into the cerebrospinal fluid (CSF) of neurosurgical patients.
  • To investigate the impact of meningeal reaction and brain damage severity on CZON's CSF penetration.
  • To determine the potential of CZON for treating CNS infections in this patient population.

Main Methods:

  • Twenty neurosurgical patients received a 2g intravenous dose of cefuzonam (CZON).

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  • Serum and CSF concentrations of CZON were measured at baseline and at 1, 2, 4, and 6 hours post-administration.
  • Concentrations were determined using the thin-layer cup method.
  • CSF penetration ratio ([CSF]/[serum]) was calculated.

    • Main Results:

    • Peak serum CZON concentration was observed at 1 hour, rapidly declining thereafter.
    • CSF CZON concentration gradually increased, peaking at 4 hours (0.319 ± 0.313 µg/ml).
    • The CSF penetration ratio reached 5.6% at 4 hours.
    • Patients with meningeal reaction or severe brain damage showed significantly higher peak CSF concentrations of CZON.
    • CSF penetration was augmented in patients with meningeal reaction or severe brain damage.

    Conclusions:

    • Intravenous cefuzonam (CZON) demonstrates adequate penetration into the CSF of neurosurgical patients.
    • The presence of meningeal reaction and the severity of brain damage positively influence CZON's CSF penetration.
    • Achieved CSF concentrations suggest cefuzonam is a viable therapeutic option for meningitis and post-neurosurgical infections caused by susceptible bacteria like E. coli and S. pneumoniae.