Buke A Cagri, Cavusoglu Cengiz, Karasulu Ercument, Karakartal Guney
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey.
Int J Antimicrob Agents. 2003 May;21(5):452-6. doi: 10.1016/s0924-8579(03)00041-4.
Trough cerebrospinal fluid (CSF) ceftriaxone concentrations were measured daily to investigate the effect of dexamethasone on ceftriaxone penetration into CSF in adult patients with acute bacterial meningitis. Patients were divided into two groups in this double blind randomized study. In group 1 (n=6) patients were given ceftriaxone with dexamethasone whereas in group 2 (n=6) patients were only administered ceftriaxone. Plasma and CSF samples were collected at 24, 48, 72, 96 and 264 h following the study treatments. The trough CSF ceftriaxone concentrations were measured using high performance liquid chromatography (HPLC) and microbiological assay. CSF ceftriaxone concentrations were 3.21 mg/l at 24 h in group 1 and 4.85 mg/l at the same time in group 2 by HPLC. Although microbiological assay results were lower than HPLC the trough CSF ceftriaxone concentrations in dexamethasone group were at least 10(3) times higher than the minimum inhibitory concentrations of the susceptible strains. It was concluded that the ceftriaxone concentration in CSF was adequate and ceftriaxone penetration was not significantly affected by concomitant dexamethasone use in adult patients with acute bacterial meningitis.
每日测量脑脊液（CSF）中头孢曲松的谷浓度，以研究地塞米松对急性细菌性脑膜炎成年患者头孢曲松渗入脑脊液的影响。在这项双盲随机研究中，患者被分为两组。第1组（n = 6）患者接受头孢曲松联合地塞米松治疗，而第2组（n = 6）患者仅给予头孢曲松治疗。在研究治疗后的24、48、72、96和264小时采集血浆和脑脊液样本。使用高效液相色谱法（HPLC）和微生物学测定法测量脑脊液中头孢曲松的谷浓度。通过HPLC检测，第1组在24小时时脑脊液中头孢曲松浓度为3.21mg/l，第2组在同一时间为4.85mg/l。尽管微生物学测定结果低于HPLC，但地塞米松组脑脊液中头孢曲松的谷浓度至少比敏感菌株的最低抑菌浓度高10³倍。得出的结论是，在急性细菌性脑膜炎成年患者中，脑脊液中头孢曲松浓度足够，同时使用地塞米松对头孢曲松的渗入没有显著影响。
