Lack of penetration of cephacetril into the cerebro-spinal fluid of patients without meningitis.

Six neurosurgical patients were given 2-4 g cephacetril intravenously at six hourly intervals. Serum and cerebrospinal fluid (CSF) concentrations were determined. Cephacetril activity was not detectable in the CSF when the blood-CSF barrier was intact. In two patients with increased CSF cell counts cephacetril was found in the CSF in low concentrations (0.1-0.8 mcg/ml). Our investigations show that cephacetril does not penetrate into the CSF unless there is an inflammation or other impairment of the blood-CSF barrier. Thus we could not confirm the results of some authors who found cephacetril in therapeutically effective concentrations in the CSF of healthy persons.