[Penetration of cefotiam dihydrochloride into cerebrospinal fluid (author's transl)]

Abstract

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.