Munemoto S, Nomura M, Ishiguro S, Kuroda E, Nakashima Y
Department of Neurosurgery, Ishikawa Prefectural Central Hospital.
Jpn J Antibiot. 1992 Oct;45(10):1275-81.
A patient of subarachnoid hemorrhage was treated with spinal CSF drainage. Serratia marcescens meningitis occurred because of the spinal CSF drainage. The organism was multiresistant and refractory to antibiotics including piperacillin, imipenem, gentamicin and cephaloridine. It was sensitive to ceftazidime (CAZ). Treatment with CAZ resulted in clinical improvement associated with rapid clearing of the organism from CSF. CAZ serum level was high enough and CAZ penetration into the CSF was satisfactory. According to the evaluation of CAZ concentrations in serum and CSF, two regimens of treatment were recommended. One is an administration of CAZ 1 g x 4 times/day. Another is a combination with CAZ administration 2 g x 2 times/day and followed by 1 g x 4 times/day. The results suggest that CAZ is an extremely effective antibiotic for meningitis caused by CAZ-susceptible bacteria.
一名蛛网膜下腔出血患者接受了脊髓脑脊液引流治疗。因脊髓脑脊液引流发生了粘质沙雷氏菌脑膜炎。该菌对包括哌拉西林、亚胺培南、庆大霉素和头孢利定在内的抗生素多重耐药且耐药难治。它对头孢他啶（CAZ）敏感。用头孢他啶治疗后临床症状改善，脑脊液中的细菌迅速清除。头孢他啶血清水平足够高，且其在脑脊液中的渗透情况令人满意。根据对血清和脑脊液中头孢他啶浓度的评估，推荐了两种治疗方案。一种是每日4次，每次1g头孢他啶给药。另一种是先每日2次，每次2g头孢他啶给药，随后每日4次，每次1g给药。结果表明，头孢他啶对于由对其敏感的细菌引起的脑膜炎是一种极其有效的抗生素。
