title: Entry of ciprofloxacin into cerebrospinal fluid during bacterial, viral and tuberculous meningitis.
abstract: We studied the entry of ciprofloxacin into the cerebrospinal fluid (CSF) in 37 patients with various types of meningitis (bacterial meningitis 10 patients, viral 12 patients, tuberculous 7 patients). Eight patients were in the control group with normal CSF finding. Mean ciprofloxacin concentrations in the CSF 50-60 minutes after 200 mg of ciprofloxacin was given in infusion were 0.20 +/- 0.12 mg/L in patients with bacterial meningitis, which was significantly higher than in other tested groups (p = 0.0325). Ciprofloxacin achieved concentrations in the CSF 6.5-39% of serum (mean value 15% +/- 9%) in the bacterial meningitis group, while in the groups with viral and tuberculous meningitis the levels were significantly lower (approximately 9% of serum) but still higher than in the control group (approximately 5% of serum). Our data suggest that ciprofloxacin should be very cautiously used in selected patients with bacterial meningitis caused by multiple resistant strains of gram negative bacteria.
authors.affiliation: University Hospital for Infectious Diseases, Dr Fran Mihaljević Zagreb, Croatia, Yu.
authors.forename: B
authors.initials: B
authors.lastname: Barsić
authors.forename: J
authors.initials: J
authors.lastname: Himbele
authors.forename: I
authors.initials: I
authors.lastname: Beus
authors.forename: S
authors.initials: S
authors.lastname: Schönwald
authors.forename: E
authors.initials: E
authors.lastname: Marton
authors.forename: M
authors.initials: M
authors.lastname: Lisić
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000134:cerebrospinal fluid / Q000188:drug therapy; D002939:Ciprofloxacin / Q000134:cerebrospinal fluid* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D008581:Meningitis / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D008587:Meningitis, Viral / Q000134:cerebrospinal fluid / Q000188:drug therapy; D008875:Middle Aged; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid / Q000188:drug therapy
chemical_list: D002939:Ciprofloxacin