Průnik B-laktamových antibiotik do likvoru a jeho vztah k markerům zánětu v průběhu invazivní bakteriální infekce

• Main Author: Prášil, Petr
• Other Authors: Buchta, Vladimír
• Format: Doctoral Thesis
• Language: Czech
• Published: 2010
• Online Access: http://www.nusl.cz/ntk/nusl-299730

Penetration of β-lactam antibiotics into cerebrospinal fluid and its relationship to inflammatory markers during invasive bacterial infection Aim: The penetration of β-lactam antibiotics (ceftriaxone, crystalic penicillin G - potassium salt and cefotaxime) into the cerebrospinal fluid (CSF) was estabilished and the correlation between the penetration and laboratory markers of inflammation was evaluated. Materials and methods: Levels of β-lactam antibiotics in serum and CSF were determined in 24 patients (76 samples). In all patients (n = 24) the CSF/serum ratio for antibiotics was calculated and it was correlated with laboratory markers of inflammation (C-reactive protein, fibrinogen, and CSF numbers of neutrophils). Besides, CSF was examined by a modified bactericidal test in patients (n = 13) with positive bacterial culture. In 14 patients (28 samples) levels of serum antibiotic concentration, both before and after its administration, were measured. Results: Serum levels of ceftriaxone before and after administration (31.2 mg/l ± SD 12.29 and 300.0 mg/l ± SD 125.9, respectively) differed with a statistical significance (p = 0.000156). Further, a significant difference between value of inflammatory markers and value of CSF/serum ratio (Kl/s) of ceftriaxone was observed. Patients with ratio values...