Cerebrospinal Fluid Linezolid Concentrations in Postneurosurgical Central Nervous System Infections

Villani, Paola; Regazzi, Mario; Marubbi, Francesca; Viale, Pierluigi; Pagani, Léonardo; Cristini, Francesco; Cadeo, Barbara; Carosi, Giampiero; Bergomi, Riccardo

doi:10.1128/aac.46.3.936-937.2002

Cited by 113 publications

(72 citation statements)

References 7 publications

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“…Times above MIC in CSF were 99.8% and 57.2% for pathogens with MICs of 2 mg/liter and 4 mg/liter, respectively. Regarding CSF, the main pharmacokinetic parameters are in agreement with previously published results from patients with gram-positive community-acquired and nosocomial CNS infections (13,17,23). Our study also confirms the relative delay in CSF linezolid peak concentrations (240 min versus 60 min for plasma after bolus infusion), which is in agreement with the amphiphilic properties of the substance (6).…”

supporting

confidence: 91%

“…Linezolid is predominantly bacteriostatic and has a broad spectrum of activity against gram-positive pathogens (3,6,18). The efficacy of linezolid for the treatment of gram-positive central nervous system (CNS) infections has been demonstrated recently (17,21,22,23). Importantly, however, limited data are available on CSF pharmacokinetics of linezolid in patients with acute neurological illnesses requiring mechanical ventilation and hemodynamic support.…”

mentioning

confidence: 99%

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Pharmacokinetics of Intravenous Linezolid in Cerebrospinal Fluid and Plasma in Neurointensive Care Patients with Staphylococcal Ventriculitis Associated with External Ventricular Drains

Beer

Engelhardt

Pfausler

et al. 2007

Antimicrob Agents Chemother

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The pharmacokinetic profile of linezolid in cerebrospinal fluid (CSF) in five neurointensive care patients with staphylococcal ventriculitis was studied. The mean area under concentration-time curve (؎ standard deviation) was 63 ؎ 18.9 mg · h/liter, with a CSF-to-plasma ratio of 0.8 ؎ 0.3. Times above MIC in CSF were 99.8% and 57.2% for pathogens with MICs of 2 mg/liter and 4 mg/liter, respectively.

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supporting

confidence: 91%

mentioning

confidence: 99%

Pharmacokinetics of Intravenous Linezolid in Cerebrospinal Fluid and Plasma in Neurointensive Care Patients with Staphylococcal Ventriculitis Associated with External Ventricular Drains

Beer

Engelhardt

Pfausler

et al. 2007

Antimicrob Agents Chemother

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“…Investigation of the CSF concentration of LZD in patients with postneurosurgical MRSA infection found that intravenous administration of LZD at a dosage of 600 mg twice a day resulted in the ratio between CSF and plasma LZD trough concentrations always exceeding one. 17) The CNS penetration of LZD is believed to be higher than that of VCM, and the effectiveness of LZD in neurosurgery has been noted.…”

Section: Discussionmentioning

confidence: 99%

Linezolid Treatment for Intracranial Abscesses Caused by Methicillin-Resistant Staphylococcus Aureus -Two Case Reports-

Saito

Aoki

Sakurai

et al. 2010

Neurol. Med. Chir.(Tokyo)

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Two patients were treated for intracranial infections involving methicillin-resistant Staphylococcus aureus (MRSA). A 30-year-old woman was admitted to our hospital for intracerebral hemorrhage related to arteriovenous malformation. After decompressive craniectomy, the patient developed an epidural abscess. MRSA was isolated from the pus culture. The infection did not improve after intravenous vancomycin (VCM) administration for 15 days. However, after administration of linezolid (LZD) for 14 days, the infection had improved, and the white blood cell count and C-reactive protein values had normalized. A 53-year-old woman had previously undergone 3 operations for craniopharyngioma before the age of 35 years. She was admitted to our hospital with fever and disturbance of consciousness. Magnetic resonance imaging with contrast medium revealed a brain abscess caused by MRSA. After 14 days of intravenous administration of VCM, the infection had not improved and intravenous administration of LZD was initiated. After administration of LZD for 14 days intravenously and 14 days orally, the infection had improved, and the white blood cell count and C-reactive protein values had normalized. VCM is highly effective against MRSA infection, but penetration into the central nervous system (CNS) is poor. LZD has good CNS penetration, so should be considered for secondline antibiotic therapy for VCM-resistant intracranial MRSA infection.

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“…12 Intravenous linezolid also appears to be a safe and effective therapy for vancomycin-resistant enterococcus meningitis [13][14][15] and linezolid achieved sufficient CSF concentrations to bring about clinical and bacteriological cure. 16,17 Based on our experience and the data reported to date, i.t. VCM might be a safe and effective second-line treatment for Staphylococcal CNS infections in immunocompromised patients.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of meningoencephalitis caused by methicillin-resistant Staphylococcus aureus with intrathecal vancomycin in an allogeneic peripheral blood stem cell transplant recipient

Matsubara

Makimoto

Higa

et al. 2003

Bone Marrow Transplant

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Summary:Methicillin-resistant Staphylococcus aureus (MRSA) is a common infectious pathogen during stem cell transplantation. We report a case of meningoencephalitis with multiple abscess formation caused by MRSA, which occurred in a 4-year-old boy soon after allogeneic peripheral blood stem cell transplantation. We successfully cured the infection with a combination of intravenous and intrathecal vancomycin.

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Cerebrospinal Fluid Linezolid Concentrations in Postneurosurgical Central Nervous System Infections

Cited by 113 publications

References 7 publications

Pharmacokinetics of Intravenous Linezolid in Cerebrospinal Fluid and Plasma in Neurointensive Care Patients with Staphylococcal Ventriculitis Associated with External Ventricular Drains

Pharmacokinetics of Intravenous Linezolid in Cerebrospinal Fluid and Plasma in Neurointensive Care Patients with Staphylococcal Ventriculitis Associated with External Ventricular Drains

Linezolid Treatment for Intracranial Abscesses Caused by Methicillin-Resistant Staphylococcus Aureus -Two Case Reports-

Successful treatment of meningoencephalitis caused by methicillin-resistant Staphylococcus aureus with intrathecal vancomycin in an allogeneic peripheral blood stem cell transplant recipient

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