ppi-0903 and Postoperative-Complications

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

A previously healthy 48-year-old active duty man, who had been treated for an elbow abscess 3 weeks earlier, presented to an emergency department in Bahrain with tachycardia, pericardial friction rub and jugular venous distention. Cardiac tamponade was confirmed on transthoracic echocardiogram and he was taken for emergent pericardiocentesis. Pericardial fluid cultures grew community-acquired methicillin-resistant

Topics: Anti-Bacterial Agents; Ceftaroline; Cephalosporins; Drug Hypersensitivity Syndrome; Drug Therapy, Combination; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Myocarditis; Pericardial Effusion; Pericardiectomy; Pericarditis; Postoperative Complications; Staphylococcal Infections; Steroids; Treatment Outcome; Vancomycin

A female patient 23 years old was admitted to the medical intensive care unit due to sudden loss of consciousness and seizures. At the time of admition observed lack of consciousness, seizures and severe critical condition was observed. Meningitis and septic shock were diagnosed. Based on computed tomography performed on the first day--inflammation of the sinuses soft tissues was diagnosed. Suspected cause of infection was performed 6 weeks earlier surgical correction of the nasal septum. In the next stage of treatment on the seventh day after admission the functional endoscopic sinus surgery was performed. Due to massive tissue hypoperfusion the necrosis in the skin of the lower limbs occurred. Due to the lack of effectiveness antimicrobial therapy use of intravenous ceftaroline was administrated. Effective treatment allowed in day 11 to wean the patient from the ventilator. At the day 26 the patient was transferred to a hospital in the place of residence.

Topics: Anti-Bacterial Agents; Ceftaroline; Cephalosporins; Female; Humans; Intensive Care Units; Meningitis, Bacterial; Nasal Septum; Nasal Surgical Procedures; Postoperative Complications; Shock, Septic; Young Adult