Journal Article

Concentrations of fosfomycin in the cerebrospinal fluid of neurointensive care patients with ventriculostomy-associated ventriculitis

Bettina Pfausler, Heinrich Spiss, Peter Dittrich, Markus Zeitlinger, Erich Schmutzhard and Christian Joukhadar

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 53, issue 5, pages 848-852
Published in print May 2004 | ISSN: 0305-7453
Published online May 2004 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dkh158
Concentrations of fosfomycin in the cerebrospinal fluid of neurointensive care patients with ventriculostomy-associated ventriculitis

Show Summary Details

Preview

Objective: The present study was performed to test the ability of fosfomycin to penetrate into the CSF of neurointensive care patients with ventriculostomy-associated ventriculitis.

Patients and methods: Six patients requiring neurointensive care monitoring, including extraventricular drainage due to secondary obstructive hydrocephalus, were enrolled into the study. All patients received 8 g of fosfomycin intravenously three times a day over a period of at least 5 days. Concentrations of fosfomycin in the CSF and plasma were measured after single-dose administration and at steady state.

Results: Mean values of the fosfomycin area under the time–concentration curves for the dosing interval of 8 h (AUC8) were 929 ± 280 and 225 ± 131 mg·h/L for plasma and CSF after single-dose administration, respectively (P < 0.03). The ratios of the AUC8 for CSF to the AUC8 for plasma were 0.23 ± 0.07 after a single dose and 0.27 ± 0.08 following multiple doses (P > 0.05, not significant). Additional in vitro experiments have shown that fosfomycin exerts non-concentration-dependent microbial growth inhibition. At steady state, the time above MIC (t > MIC) values were 98%, 92% and 61% for pathogens with MIC values of 8, 16 and 32 mg/L, respectively.

Conclusion: The present pharmacokinetic study indicates that 8 g of fosfomycin three times per day should provide sufficient antimicrobial concentrations in the CSF for the overall treatment period. Thus, the co-administration of fosfomycin could be useful for the treatment of ventriculitis caused by susceptible pathogens.

Keywords: Keywords: CSF, intensive care, pharmacokinetics, humans

Journal Article.  3672 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.