Kojima T, Waga S, Morikawa A, Okada M, Furuno M, Shimizu T
Jpn J Antibiot. 1982 Apr;35(4):1063-7.
It is well recognized that only very low concentration of antibiotics is obtained from cerebrospinal fluid (CSF) despite its high blood concentration. It has been attributed to the blood-brain and blood-CSF barriers. Penetration of CTM into CSF was studied in 7 patients. Two of them were complicated with septic meningitis, and others were not infected. CTM was administered intravenously and samples were obtained from both serum and CSF from 15 minutes to 4 hours for determination of concentration of the antibiotics. In 2 patients with meningitis, the peak level of CTM in CSF after intravenous injection of 2 g and 1 g of CTM was 197 mcg/ml (46% of peak serum concentration), and 17.3 mcg/ml (38% of peak serum level), respectively. In noninfected patients the peak level of CTM in CSF after intravenous injection of 1g of CTM was from 0.3 mcg/ml to 1.9 mcg/ml (0.84% approximately 3.64% of peak serum concentration). We conclude that the percent penetration of CTM into CSF increases in the presence of the inflamed meninges and that prophylactic dosage of CTM for postoperative meningitis will be intravenous administration of 2 g of CTM in adults.
尽管脑脊液(CSF)中的抗生素血药浓度很高,但人们普遍认识到从脑脊液中获得的抗生素浓度非常低。这归因于血脑屏障和血脑脊液屏障。对7例患者进行了头孢噻肟(CTM)穿透脑脊液的研究。其中2例并发化脓性脑膜炎,其他患者未感染。静脉注射CTM后,在15分钟至4小时内从血清和脑脊液中采集样本,以测定抗生素浓度。在2例脑膜炎患者中,静脉注射2g和1g CTM后,脑脊液中CTM的峰值水平分别为197 mcg/ml(占血清峰值浓度的46%)和17.3 mcg/ml(占血清峰值水平的38%)。在未感染患者中,静脉注射1g CTM后,脑脊液中CTM的峰值水平为0.3 mcg/ml至1.9 mcg/ml(约占血清峰值浓度的0.84%至3.64%)。我们得出结论,在脑膜发炎的情况下,CTM穿透脑脊液的百分比会增加,并且成人术后脑膜炎的CTM预防性剂量为静脉注射2g CTM。