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[The penetration of cephalosporins across the blood-brain barrier and its clinical significance].
Y Y Zhang, P J Wu, Q Zhang
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Abstract
The penetration of Cefuroxime (CXM), Ceftazidime (CTZ), Cefotaxime (CTX), Ceftizoxime (CZX), and Ceftriaxone (CTRX) across the blood-brain barrier was studied in 119 patients with or without meningitis after an intravenous injection of 2 grams. Cephalosporins were undetectable or their concentrations very low in the cerebrospinal fluid (CSF), when there was no inflammation in the meninges. On the contrary, the mean CSF concentrations of cephalosporins were 2.21-5.36 micrograms/ml and the CSF/serum ratios 3.73-31.80% in acute stage of purulent meningitis. The CSF levels of all the five cephalosporins were much higher than the mean MICs of the common pathogens of bacterial meningitis as well as that of Enterobacteriaceae. It is thus shown that these five new cephalosporins are useful for treatment of meningitis including those caused by gram-negative bacilli.