Borderon J C, Prieur D, Huguet B
Nouv Presse Med. 1981 Feb 26;10(8):580-4.
Cefotaxime concentrations obtained in the C.S.F. of twelve children suffering from bacterial meningitis and undergoing monotherapy with this antibiotic are reported. Among these 12 patients, 4 infants (aged 3 to 28 days) had neonatal meningitis (due to Serratia marcescens, Proteus mirabilis, Enterobacter cloacae, Escherichia coli); one infant (2 months old) had meningitis due to Salmonella panama; 5 children (aged 5 to 11 months) had meningitis due to Haemophilus; and 2 children had belated superinfection caused by a ventriculo-peritoneal shunt due to Klebsiella pneumoniae and Pseudomonas aeruginosa. Cefotaxime concentration reached a high level as early as one hour after the injection (3 to 19 mcg/ml), remained at this level until the fifth hour (1,8 to 14,3 mcg/ml) and decreased without significant proportionality with the disappearance of the inflammatory symptoms. Compared to the M.I.C. of the bacteria which caused the twelve cases of meningitis, these results show that the concentrations in the C.S.F. are much higher than the M.I.C.'s. These results are comparable to those of previous studies. Cefotaxime diffuses in the C.S.F. and gives concentrations which ensures an antibacterial activity that ampicillin could not reach: in particular against Haemophilus influenzae and enterobacteriaceae.
报告了12例患细菌性脑膜炎且正在接受这种抗生素单一疗法的儿童脑脊液中的头孢噻肟浓度。在这12例患者中,4例婴儿(年龄3至28天)患有新生儿脑膜炎(由粘质沙雷氏菌、奇异变形杆菌、阴沟肠杆菌、大肠杆菌引起);1例婴儿(2个月大)患有巴拿马沙门氏菌引起的脑膜炎;5例儿童(年龄5至11个月)患有流感嗜血杆菌引起的脑膜炎;2例儿童因脑室-腹腔分流导致肺炎克雷伯菌和铜绿假单胞菌引起迟发性二重感染。头孢噻肟浓度在注射后1小时就达到较高水平(3至19微克/毫升),直至第5小时一直保持在该水平(1.8至14.3微克/毫升),且随着炎症症状的消失而不成比例地下降。与导致这12例脑膜炎的细菌的最低抑菌浓度相比,这些结果表明脑脊液中的浓度远高于最低抑菌浓度。这些结果与之前的研究结果相当。头孢噻肟可在脑脊液中扩散,并产生能确保氨苄西林无法达到的抗菌活性的浓度:特别是对流感嗜血杆菌和肠杆菌科细菌。