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CSF pharmacokinetics of ceftazidime in neurosurgical patients with an external ventriculostomy

Pharmakokinetik von Ceftazidim im Liquor cerebrospinalis bei neurochirurgischen Patienten mit externer Liquordrainage

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Summary

In 11 neurosurgical patients (seven women, four men, aged 22–73 years) undergoing external ventriculostomy, serum and cerebrospinal fluid (CSF) pharmacokinetics of ceftazidime (CAZ) administered as a chemoprophylactic agent were evaluated. Concentrations of CAZ in CSF correlated significantly (p<0.05) with serum concentrations and with leucocyte counts in CSF. Peak concentrations in CSF (range 0–25.5 mg/l) exceeded the MIC90 ofStaphylococcus species in two and ofPseudomonas andEnterobacter species in five of 11 patients. The MIC90 values of the other relevant bacteria causing CNS infections in these patients were surpassed in nine of 11 patients.

Zusammenfassung

Bei 11 neurochirurgischen Patienten (sieben Frauen, vier Männer, Alter 22–73 Jahre) mit externer Liquordrainage wurden pharmakokinetische Daten von Ceftazidim (Applikation zur Chemoprophylaxe) in Serum und Liquor cerebrospinalis bestimmt. Zwischen den CAZ-Konzentrationen im Liquor und den Serumkonzentrationen sowie der Zahl der Leukozyten im Liquor bestanden signifikante (p<0.05) Korrelationen. Die maximalen Liquorkonzentrationen (Bereich 0–25.5 mg/l) übertrafen die MHK90 vonStaphylococcus spp. bei zwei und vonPseudomonas undEnterobacter spp. bei fünf von 11 Patienten. Die MHK90-Werte der anderen bei ZNS-Infektionen dieser Patienten wichtigen Erreger wurden bei zumindest neun von 11 Patienten überschritten.

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Authors and Affiliations

  1. Abteilung für Klinische Pharmakologie, Haus 74IV Klinikum der Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, D-6000, Frankfurt am Main 70

    U. Fuhr,  S. Harder, S. Häfner &  A. H. Staib

  2. Abteilung für Allgemeine Neurochirurgie, Zentrum der Neurologie und Neurochirurgie, Klinikum der Johann Wolfgang Goethe-Universität, Schleusenweg 2-16, D-6000, Frankfurt am Main 70

    R. Lorenz &  D. Rosenthal

Authors
  1. U. Fuhr
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  2. S. Harder
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  3. S. Häfner
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  4. A. H. Staib
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  5. R. Lorenz
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  6. D. Rosenthal
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Fuhr, U., Harder, S., Häfner, S. et al. CSF pharmacokinetics of ceftazidime in neurosurgical patients with an external ventriculostomy. Infection 17, 15–16 (1989). https://doi.org/10.1007/BF01643492

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  • DOI: https://doi.org/10.1007/BF01643492

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