The Pharmacokinetics of Moxifloxacin in Cerebrospinal Fluid Following Intravenous Administration

Nohren, John; Namtu, Katie; Peloquin, Charles A.; Messina, Allison F.; Tuite, Gerald F.; Berman, David M.

doi:10.1097/inf.0000000000002655

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…Detection of Mycoplasma Hominis can be challenging since they lack peptidoglycan cell wall which renders them unidentifiable by gram staining [5]. In addition to this, they grow very slowly on routine culture media and require a specific blood agar medium for their detection [1,6]. Due to this, there is a likelihood that Mycoplasma Hominis infections may remain undiagnosed or diagnosed late in infants presenting with clinical signs and symptoms [2].…”

Section: Discussionmentioning

confidence: 99%

“…Use of pathogen-specific primers in 16S RNA analysis results in rapid detection of the specific organism [4]. Prematurity, low birth weight, and neural tube defects are recognized to be the most common risk factors for neonatal meningitis with Mycoplasma Hominis [6]. However, it has also been seen in term neonates with no neurological birth malformations [1,3].…”

Section: Discussionmentioning

confidence: 99%

“…Moxifloxacin, a fourth-generation fluoroquinolone is preferred because of its ability to concentrate in CSF and its bactericidal effects in CNS infections [1,12,13]. Although there are cases which were successfully treated with Moxifloxacin monotherapy [1,6], there is a risk of development of resistance with fluoroquinolones during treatment [9,14,15]. Our literature search revealed only two reported cases of neonates who were given Moxifloxacin in combination with another antibiotic for Mycoplasma Hominis meningitis [3,5] (Table 1).…”

Section: Discussionmentioning

confidence: 99%

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Mycoplasma hominis meningitis in an extremely preterm newborn: a case report

2021

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Background Mycoplasma Hominis is a micro-organism which is a part of the human genitourinary tract flora. Neonates are susceptible to acquire this pathogen either in utero or through vertical transmission. In rare cases, it may cause central nervous system infections with severe morbidity and mortality in preterm and term neonates. Case presentation We present a case of Mycoplasma Hominis meningitis in an extremely preterm neonate who presented with lethargy, tachycardia and seizures on day 7 of life. There was no history of maternal systemic or genitourinary infection during pregnancy and at the time of delivery. Empirical antibiotic therapy for neonatal meningitis was commenced after sending blood and cerebrospinal fluid cultures. Cerebrospinal fluid analysis showed pleocytosis with neutrophilic predominance, but no bacteria was identified on gram staining. Blood culture yielded no growth of any bacterial pathogen. However, growth of Mycoplasma Hominis was suspected in cerebrospinal fluid culture which was confirmed by 16S ribosomal ribonucleic acid (RNA) polymerase chain reaction analysis. Subsequently, antibiotics were changed to Moxifloxacin and Doxycycline which were given for a total duration of 6 weeks. Multiple cerebrospinal fluid cultures were performed during this treatment. No growth of any pathogen was identified on any of these cerebrospinal fluid cultures. Conclusions We report a rare case of Mycoplasma Hominis meningitis in an extremely preterm neonate which was successfully treated with a combination therapy of Moxifloxacin and Doxycycline. It is important to consider the possibility of Mycoplasma Hominis meningitis in neonates who present with clinical signs and pleocytosis in cerebrospinal fluid but negative gram staining and no growth on conventional culture media.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mycoplasma hominis meningitis in an extremely preterm newborn: a case report

2021

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“…An application of TDM for studying the PK of antibiotics in preterm neonates was reported in three interesting case reports of preterm newborns affected by Mycoplasma hominis meningitis and treated with moxifloxacin [ 212 , 213 , 214 ]. In particular, in the case report described by Yeung T and colleagues, an extremely preterm male (GA = 25 weeks) was treated with doxycycline (4 mg/kg IV every 24 h) and moxifloxacin (5 mg/kg IV every 24 h).…”

Section: Pk Of Antibiotics In Pretermsmentioning

confidence: 99%

Use of Antibiotics in Preterm Newborns

et al. 2022

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Due to complex maturational and physiological changes that characterize neonates and affect their response to pharmacological treatments, neonatal pharmacology is different from children and adults and deserves particular attention. Although preterms are usually considered part of the neonatal population, they have physiological and pharmacological hallmarks different from full-terms and, therefore, need specific considerations. Antibiotics are widely used among preterms. In fact, during their stay in neonatal intensive care units (NICUs), invasive procedures, including central catheters for parental nutrition and ventilators for respiratory support, are often sources of microbes and require antimicrobial treatments. Unfortunately, the majority of drugs administered to neonates are off-label due to the lack of clinical studies conducted on this special population. In fact, physiological and ethical concerns represent a huge limit in performing pharmacokinetic (PK) studies on these subjects, since they limit the number and volume of blood sampling. Therapeutic drug monitoring (TDM) is a useful tool that allows dose adjustments aiming to fit plasma concentrations within the therapeutic range and to reach specific drug target attainment. In this review of the last ten years’ literature, we performed Pubmed research aiming to summarize the PK aspects for the most used antibiotics in preterms.

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Other Mycoplasma Species

Shah¹

2023

Principles and Practice of Pediatric Infectious Diseases

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The Pharmacokinetics of Moxifloxacin in Cerebrospinal Fluid Following Intravenous Administration

Cited by 6 publications

References 10 publications

Mycoplasma hominis meningitis in an extremely preterm newborn: a case report

Mycoplasma hominis meningitis in an extremely preterm newborn: a case report

Use of Antibiotics in Preterm Newborns

Other Mycoplasma Species

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