Brückner O, Collmann H, Hoffmann H G
Intensive Care Med. 1982 Jan;8(1):33-8. doi: 10.1007/BF01686851.
In three groups of patients levels of cefotaxime in serumand cerebrospinal fluid were determined. Therapeutic value and efficacy are discussed in meningitis patients. Nine concentrations of cefotaxime in lumbar and ventricular CSF out of 19 in a group of seven neurosurgical patients with mild to moderate impairment of the blood-CSF-barrier were higher than 0.5 micrograms/ml. In seven determinations in a second group of six patients with no or very little dysfunction of the blood-cerebrospinal-fluid barrier only twice cefotaxime was not detectable in lumbar CSF. Concentrations of cefotaxime in 25 determinations of lumbar or ventricular CSF in six patients with bacterial meningitis ranged from 1.1 micrograms/ml to 19.2 micrograms/ml. Treatment with cefotaxime alone was successful in a patient with E. coli meningitis and ventriculitis after infection of a ventriculo-atrial shunt and in another patient with pneumococcal meningitis and penicillin allergy. The other four patients with bacterial meningitis were treated successfully by antibiotics including cefotaxime.
对三组患者的血清和脑脊液中的头孢噻肟水平进行了测定。并讨论了其在脑膜炎患者中的治疗价值和疗效。在一组7例血脑屏障轻度至中度受损的神经外科患者中，19次腰椎和脑室脑脊液中的头孢噻肟有9次浓度高于0.5微克/毫升。在第二组6例血脑屏障无功能障碍或功能障碍极小的患者的7次测定中，腰椎脑脊液中仅2次未检测到头孢噻肟。6例细菌性脑膜炎患者的25次腰椎或脑室脑脊液头孢噻肟浓度在1.1微克/毫升至19.2微克/毫升之间。单独使用头孢噻肟治疗，一名因脑室心房分流感染后患有大肠杆菌脑膜炎和脑室炎的患者以及另一名对青霉素过敏的肺炎球菌脑膜炎患者取得了成功。其他4例细菌性脑膜炎患者通过包括头孢噻肟在内的抗生素治疗成功。
