ppi-0903 and Cerebral-Ventriculitis

Owing to its antibacterial properties, ceftaroline could be attractive for prevention or treatment of bacterial post-neurosurgical meningitis/ventriculitis. However, few data are available concerning its meningeal concentrations.. To investigate ceftaroline CSF pharmacokinetics in ICU patients with an external ventricular drain (EVD).. Patients received a single 600 mg dose of ceftaroline as a 1 h intravenous infusion. Blood and CSF samples were collected before and 0.5, 1, 3, 6, 12 and 24 h after the end of the infusion. Concentrations were assayed in plasma and CSF by LC-MS/MS. A two-step compartmental pharmacokinetic analysis was conducted. Ceftaroline plasma data were first analysed, and thereafter plasma parameters estimated and corrected for protein binding of 20% were fixed to fit unbound CSF concentrations. In the final model, parameters for both plasma and CSF data were simultaneously estimated.. Nine patients with an EVD were included. The Cmax was 18.29 ± 3.33 mg/L in plasma (total concentrations) and at 0.22 ± 0.17 mg/L in CSF (unbound concentration). The model-estimated CSF input/CSF output clearance ratio was 9.4%, attesting to extensive efflux transport at the blood-CSF barrier.. Ceftaroline CSF concentrations are too low to ensure prophylactic protection against most pathogens with MICs between 1 and 2 mg/L, owing to its limited central distribution.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Ceftaroline; Cephalosporins; Cerebral Ventricles; Cerebral Ventriculitis; Cerebrospinal Fluid; Chromatography, Liquid; Drainage; Female; Humans; Infusions, Intravenous; Intensive Care Units; Male; Meningitis, Bacterial; Middle Aged; Models, Theoretical; Neurosurgical Procedures; Postoperative Complications; Tandem Mass Spectrometry; Young Adult