Gaillard J L, Silly C, Le Masne A, Mahut B, Lacaille F, Cheron G, Abadie V, Hubert P, Matha V, Coustere C
Laboratoire de Microbiologie, Hôpital Necker-Enfants Malades, Paris, France.
Antimicrob Agents Chemother. 1995 Jan;39(1):253-5. doi: 10.1128/AAC.39.1.253.
The penetration of amikacin into the cerebrospinal fluid (CSF) was studied with 16 children (mean age, 1 year and 9 months; range, 4 months to 8 years) with community-acquired bacterial meningitis. Amikacin was given intravenously at a dose of 7.5 mg/kg of body weight twice daily. CSF was collected on day 1, at the expected peak concentration of amikacin in CSF. The mean (standard deviation) concentration of amikacin in CSF was 1.65 (1.6) mg/liter. Concentrations of amikacin in CSF correlated significantly with CSF glucose levels on admission. The mean concentrations of amikacin in CSF were 2.9, 1.1, and 0.20 mg/liter in patients with CSF glucose levels of < 1, 1 to 2, and > 2 mmol/liter, respectively. Thus, amikacin penetrates the blood-brain barrier substantially in children with bacterial meningitis and achieves particularly high concentrations when CSF glucose level is < 1 mmol/liter on admission.
对16例社区获得性细菌性脑膜炎患儿（平均年龄1岁9个月，范围4个月至8岁）进行了阿米卡星透过血脑屏障进入脑脊液（CSF）的研究。阿米卡星静脉给药，剂量为7.5 mg/kg体重，每日2次。在第1天，即脑脊液中阿米卡星预期达到峰值浓度时采集脑脊液。脑脊液中阿米卡星的平均（标准差）浓度为1.65（1.6）mg/升。脑脊液中阿米卡星的浓度与入院时脑脊液葡萄糖水平显著相关。脑脊液葡萄糖水平<1、1至2和>2 mmol/升的患者，脑脊液中阿米卡星的平均浓度分别为2.9、1.1和0.20 mg/升。因此，在细菌性脑膜炎患儿中，阿米卡星能大量透过血脑屏障，当入院时脑脊液葡萄糖水平<1 mmol/升时，可达到特别高的浓度。
