[Prophylactic administration of an antibiotic in neurosurgical operations--penetration of cefotiam into the cerebrospinal fluid].

Various antibiotics are widely used for the purpose of protection against postoperative infections. Neurosurgeon must select the effective antibiotics to bacterium, that which penetrated enough to the intracranial organ through the blood-brain barrier. Eighteen cases with ventriculo-peritoneal shunt received intravenous drip infusion of cefotiam (CTM) and the concentration of CTM in blood and cerebrospinal fluid (CSF) was measured. The conclusion drawn from this study on penetration of CTM is summarized as follows: The concentration of CTM in CSF and its ratio to that of serum (CSF/serum %) showed the values of 0.543 microgram/ml (3.66%) in the group of 1 g CTM injection and 0.900 microgram/ml (4.02%) in the group of 2 g CTM injection, 2 hours after an intravenous administration. The concentration of CTM in CSF were gradually decreased in comparison with antibiotic levels in the blood. The most cases of 1 g or 2 g intravenous administration were able to get the sufficient concentration in the CSF, which exceeds MIC (minimal inhibitory concentration) against Gram-positive cocci and Gram-negative bacilli. As a result of penetration of CTM into cerebrospinal fluid, we recommend the intermittent intravenous injection of 2 g CTM for prophylaxis of postoperative infections.