Latif R, Dajani A S
Antimicrob Agents Chemother. 1983 Jan;23(1):46-8. doi: 10.1128/AAC.23.1.46.
We evaluated the diffusion of ceftriaxone into the cerebrospinal fluid of 27 infants and children with meningitis who were receiving conventional antimicrobic therapy. Ceftriaxone was administered as a single 75 mg/kg dose and was given early or late or both in the course of the illness. Three hours after a dose, the mean cerebrospinal fluid ceftriaxone level was 5.7 micrograms/ml in patients studied early in the course of meningitis and 2.1 micrograms/ml in patients studied later in the illness. Six hours after a dose, the mean cerebrospinal fluid ceftriaxone levels early and late in meningitis were 7.2 and 2.5 micrograms/ml, respectively. The diffusion did not correlate with the leukocyte count or the protein or glucose content of the cerebrospinal fluid. Serial, simultaneous cerebrospinal fluid and plasma ceftriaxone levels were also determined in three additional patients with ventriculo-peritoneal shunt infections and external ventriculostomy drainage. The cerebrospinal fluid ceftriaxone levels in these patients ranged from 0.7 to 8.3 micrograms/ml. Our data indicate that ceftriaxone diffuses sufficiently and consistently into the cerebrospinal fluid to warrant its assessment in the treatment of meningitis.
我们评估了头孢曲松在27例接受传统抗菌治疗的患脑膜炎婴幼儿及儿童脑脊液中的扩散情况。头孢曲松以75mg/kg单剂量给药，在病程早期、晚期或两者均使用。给药3小时后，在脑膜炎病程早期接受研究的患者中，脑脊液头孢曲松平均水平为5.7μg/ml，在病程后期接受研究的患者中为2.1μg/ml。给药6小时后，脑膜炎早期和晚期脑脊液头孢曲松平均水平分别为7.2μg/ml和2.5μg/ml。这种扩散与脑脊液中的白细胞计数、蛋白质或葡萄糖含量无关。另外还对3例患有脑室-腹腔分流感染和脑室外引流的患者同时进行了脑脊液和血浆头孢曲松水平的系列测定。这些患者脑脊液中头孢曲松水平为0.7至8.3μg/ml。我们的数据表明，头孢曲松能充分且持续地扩散至脑脊液中，因此值得对其在脑膜炎治疗中的应用进行评估。
