Gentamicin-Konzentrationen im Liquorraum bei Patienten mit entzündeten und nicht entzündeten Meningen

Brückner, O.; Alexander, M.; Martens, Florian

doi:10.1007/bf01639153

Cited by 11 publications

(5 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared to gentamicin levels in CSF of meningitis patients [5] tobramycin con centrations in CSF seem to vary in an even somewhat lower range. Therapeutic levels for enteric bacilli are to be obtained only by additional intraventricular application of preservative-free drug.…”

Section: Discussionmentioning

confidence: 99%

Tobramycin Levels in Cerebrospinal Fluid of Patients with Slightly and Severely Impaired Blood-Cerebrospinal Barrier

Brückner¹,

Alexander²,

Collmann³

1981

Chemotherapy

Self Cite

View full text Add to dashboard Cite

Concentrations of tobramycin in cerebrospinal fluid (CSF) and serum of neurosurgical and of meningitis patients were determined following systemic application of 80-mg doses. Tobramycin was detectable only in 8 tests out of 17 in CSF of 11 neurosurgical patients. The highest drug amount in CSF in these tests was 0.47 µg/ml. In CSF of 7 meningitis patients with CSF cell counts ranging from 173/3 to 20,500/3 cells, tobramycin was detectable in all 11 determinations. However, the tobramycin level was above 1.0 µg/ml in only one CSF sample. These results also confirm the poor penetrability of aminoglycosides through the blood-CSF barrier for tobramycin. In proven gram-negative bacillary meningitis and tobramycin treatment, additional intraventricular aminoglycoside application is necessary to obtain effective levels in CSF. An exception may be treatment of neonatal meningitis.

show abstract

Section: Discussionmentioning

confidence: 99%

Tobramycin Levels in Cerebrospinal Fluid of Patients with Slightly and Severely Impaired Blood-Cerebrospinal Barrier

Brückner¹,

Alexander²,

Collmann³

1981

Chemotherapy

Self Cite

View full text Add to dashboard Cite

show abstract

“…Few studies have examined the CSF penetration of aminoglycosides following intravenous administration. Case series data shows an approximate CSF penetration ratio ranging from 0.08 to 0.24 in patients with inflamed meninges [69,70]. Maximum CSF concentrations of up to 2.9 mg/L for amikacin and 5.66 mg/L for gentamicin following administration of 7.5 mg/kg and 3 mg/kg respectively [69,71].…”

Section: Pharmacokinetic Considerationsmentioning

confidence: 99%

“…Case series data shows an approximate CSF penetration ratio ranging from 0.08 to 0.24 in patients with inflamed meninges [69,70]. Maximum CSF concentrations of up to 2.9 mg/L for amikacin and 5.66 mg/L for gentamicin following administration of 7.5 mg/kg and 3 mg/kg respectively [69,71]. High dose intravenous therapy is limited by the narrow therapeutic range of aminoglycosides due to nephrotoxicity and ototoxicity.…”

Section: Aminoglycosidesmentioning

confidence: 99%

Dose optimisation of antibiotics used for meningitis

Heffernan

Roberts

2021

Current Opinion in Infectious Diseases

View full text Add to dashboard Cite

Purpose of review Central nervous system (CNS) infections such as ventriculitis and meningitis are associated with significant morbidity and mortality. In part, this may be due to increased difficulties in achieving a therapeutic antibiotic concentration at the site of infection due to both the pharmacokinetic (PK) changes observed during critical illness and the reduced antibiotic penetration through the blood brain barrier. This paper reviews the pharmacodynamics (PD) and CNS PKs of antibiotics used for Gram-negative bacterial CNS infections to provide clinicians with practical dosing advice. Recent findingsRecent PK studies have shown that currently used intravenous antibiotic dosing regimens may not achieve a therapeutic exposure within the CNS, even for reportedly 'susceptible' bacteria per the current clinical meningitis breakpoints. Limited data exist for new b-lactam antibiotic/b-lactamase inhibitor combinations, which may be required for multidrug resistant infections. Intraventricular antibiotic administration, although not a new concept, has further evidence demonstrating improved patient outcomes compared with intravenous therapy alone, despite the ongoing paucity of PK studies guiding dosing recommendations. SummaryClinicians should obtain the bacterial minimum inhibitory concentration when treating patients with CNS Gram-negative bacterial infections and consider the underlying PK/PD principles when prescribing antibiotics. Therapeutic drug monitoring, where available, should be considered to guide dosing. Intraventricular therapy should also be considered for patients with ventricular drains to optimise clinical outcomes.

show abstract

“…The penetration of gentamicin into the cerebrospinal fluid has been reviewed. Adult patients received gentamicin intravenously at the standard dose and gentamicin concentration ranged from 3.9 to 9.4 µg/ml (mean, 4.8+2.0) in serum, the gentamicin concentration in the cerebrospinal fluid was about 2 µg/ml, and gentamicin treats the meningitis caused by Candida albicans a or by Citrobacter freundii [48], and in adult patients with bacterial meningitis the cerebrospinal fluid to serum ratio of gentamicin ranged from 0.058 to 0.70 (mean, 0.26) [49]. Gentamicin was administered intraventricularly at a mean dose of 2.5 mg/kg to infants with meningitis caused by Escherichia coly or by Salmonella species and gentamicin concentration in ventricular and lumbar cerebrospinal fluid ranged from 10 to 130 µg/ml 1 hour after dosing and from 8 to 85 µg/ml 6 hours after dosing [50].…”

Section: Discussionmentioning

confidence: 99%

“…Adult patients received gentamicin intravenously at the standard dose and the concentration of gentamicin in serum ranged from 3.9 to 9.4 μg/ml (mean, 4.8+2.0) and the concentration of gentamicin in the CSF was about 2 µg/ml thus gentamicin penetrates into the CSF in significant amounts and treated the meningitis caused by Candida albicans or by Citrobacter freundii [48]. Gentamicin concentration was measured in serum and in the CSF of 8 adult patients suffering from bacterial meningitis and gentamicin concentrations in CSF ranged from 0.4 to 5.7 µg/ml and CSF to serum ratio ranged from 0.058 to 0.70 (mean, 0.26) [49].…”

Section: Penetration Of Gentamicin Into the Cerebrospinal Fluid (Csf)mentioning

confidence: 99%

Clinical Pharmacology of Gentamicin

Maria Pacifici

2023

JCRCT

View full text Add to dashboard Cite

Gentamicin is an important agent for the treatment of many serious gram-negative bacillary infections. Gentamicin is the aminoglycoside of first-choice because the reliable activity against all but the most resistant gram-negative aerobes. Gentamicin preparations are available for parenteral, ophthalmic, and topical administration. The recommended intramuscular or intravenous dose of gentamicin sulphate for treatment of gram-negative organisms in adults with normal renal function is 5 to 7 mg/kg daily. For patients with renal dysfunction the interval between may be extended. The efficacy and safety of gentamicin have been reported but gentamicin may induce nephrotoxicity and/or ototoxicity in some patients. Gentamicin penetrates in significant amounts into bone, skeletal muscle, wound tissue, ischemic foot ulcers, and in subcutaneous tissue. The pharmacokinetics of gentamicin have been studied in febrile neutropenic adult patients and in healthy adult subjects and gentamicin elimination half-life is about 3 hours. The pharmacokinetics of gentamicin have been investigated in tetraplegic and in paraplegic adult patients and in healthy adult subjects and the elimination half-life of gentamicin is about 2 hours. The prophylaxis, treatment, and trials with gentamicin have been extensively reported. Gentamicin penetrates into the cerebrospinal fluid in significant amounts and treats bacterial meningitis in infants. Gentamicin is poorly transferred across the human placenta and poorly migrates into the breast-milk. The aim of this study is to review gentamicin efficacy and safety, toxicity, diffusion into body-tissues, pharmacokinetics, prophylaxis, treatment, trials, penetration into the cerebrospinal fluid, treatment of bacterial meningitis, transfer across the human placenta, and migration into the breast-milk.

show abstract

Gentamicin-Konzentrationen im Liquorraum bei Patienten mit entzündeten und nicht entzündeten Meningen

Cited by 11 publications

References 35 publications

Tobramycin Levels in Cerebrospinal Fluid of Patients with Slightly and Severely Impaired Blood-Cerebrospinal Barrier

Tobramycin Levels in Cerebrospinal Fluid of Patients with Slightly and Severely Impaired Blood-Cerebrospinal Barrier

Dose optimisation of antibiotics used for meningitis

Clinical Pharmacology of Gentamicin

Contact Info

Product

Resources

About