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Antibiotics penetrate cns

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    Effective antimicrobial therapy depends on several factors including degree of activity against the pathogen, antibiotic resistance, and when relevant, optimal tissue penetration factors. Central nervous system CNS infections illustrate these points well. The pharmacokinetic PK parameters important in antibiotic blood cerebrospinal fluid barrier BCB penetration that is important in meningitis are different and do not predict blood brain barrier BBB penetration. Recently, we had a case of Mycoplasma pneumoniae encephalitis MPE which prompted a review of the antibiotic PK determinants of BBB penetration which differ markedly from those of BCB penetration important in encephalitis.
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    Antibiotic pharmacodynamics in cerebrospinal fluid

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    Antibiotic pharmacodynamics in cerebrospinal fluid

    Barling, J. Most users should sign in with their email address. If you originally registered with a username please use that to sign in. To purchase short term access, please sign in to your Oxford Academic account above. Don't already have an Oxford Academic account?
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    The CSF half-lives of lipophilic agents, such as quinolones, are similar to those in serum and peak concentrations in CSF are achieved relatively quickly. In contrast, the pharmacokinetics of hydrophilic agents beta-lactams and vancomycin in CSF often differ from those in serum. In particular, the half-lives of these agents in CSF tend to be extended, and the time to achieve peak concentrations in CSF is delayed. Hydrophilic antibiotics, such as beta-lactams, penetrate poorly through the BBB, but CSF penetration is significantly increased in the presence of inflammation. In contrast, lipophilic antibiotics, such as quinolones, enter the CSF more efficiently and their penetration is not inflammation dependent.
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    Since concentrations in microdialysates and abscesses are not frequently available for humans, this review focuses on drug CSF concentrations. When several equally active compounds are available, a drug which comes close to these physicochemical and pharmacokinetic properties should be preferred. Several anti-infectives e. In many cases, however, pharmacokinetics have to be balanced against in vitro activity.
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