Asahi S, Mori N, Tajika Y, Kagawa M
Jpn J Antibiot. 1985 Jan;38(1):121-7.
Eleven neurosurgical patients without intracranial infection were given 4 g cefoperazone (CPZ) intravenously for 30 minutes. Ventricular drainage was performed in 10 cases, and 1 case with cisternal drainage. Eight of 11 cases showed moderate to severe ventricular dilatation. Serum and ventricular cerebrospinal fluid (CSF) concentrations of CPZ were measured for 8 hours after injection. Average peak serum concentration of CPZ was 476 micrograms/ml and the half-life was 150 minutes. Patients with obstructive hydrocephalus showed relative good penetration of CPZ in CSF (2.74 approximately 5.29 micrograms/ml). Especially, those who had severe dilatation of ventricles demonstrated sequential increased concentration (5.48 approximately 6.25 micrograms/ml at 8 hours). In poor risk patient and intracerebral hemorrhage with ventricular hemorrhage cases, who had normal range of CSF cell counts and protein, CPZ level was low, less than 2 micrograms/ml. In cases with severe subarachnoid hemorrhage, sufficient concentration (11 micrograms/ml) of CPZ was observed in cisternal CSF. The CPZ concentrations in CSF after 4 g administration did not seem to exceed comparing to 2 g dosing.
11例无颅内感染的神经外科患者静脉注射4g头孢哌酮(CPZ),持续30分钟。10例行脑室引流,1例行脑池引流。11例中有8例表现为中度至重度脑室扩张。注射后8小时测定血清和脑室脑脊液(CSF)中CPZ的浓度。CPZ的平均血清峰值浓度为476微克/毫升,半衰期为150分钟。梗阻性脑积水患者的CPZ在脑脊液中的穿透性相对较好(2.74至5.29微克/毫升)。特别是,脑室严重扩张的患者在8小时时浓度呈逐渐升高(5.48至6.25微克/毫升)。在脑脊液细胞计数和蛋白质正常范围的高危患者和脑内出血合并脑室出血病例中,CPZ水平较低,低于2微克/毫升。在严重蛛网膜下腔出血病例中,脑池脑脊液中观察到CPZ的足够浓度(11微克/毫升)。与2g给药相比,4g给药后脑脊液中CPZ的浓度似乎没有超过。