[Clinical evaluation of cefotiam in the cerebrospinal fluid of patients with ruptured cerebral aneurysms in the acute stage].
The treatment of the patients with ruptured cerebral aneurysm in acute stage is performed by direct neck clipping and cisternal drainages for preventing vasospasm. The cisternal drainage is carried out for 1 to 2 weeks' duration. The cisternal drainage has higher risk for bacterial infections in the cerebrospinal fluid (CSF). In this paper, penetration characteristics of cefotiam (CTM) in CSF were studied. CTM concentrations in CSF were measured at 1, 3 and 6 hours after intravenous drip infusion of CTM (2 g). CTM concentration in cisternal CSF was higher than that of ventricular CSF. The peak concentration in CSF was higher than 0.78 micrograms/ml and obtained at 3 hours after intravenous drip infusion. Our data suggest that CTM is a useful cephalosporin for treatment of meningitis (Staphylococcus aureus, Streptococcus pneumoniae et al.). Apart from meningitis, the higher concentration of CTM in CSF was obtained in the cases with the vasospasm. The result may support that the breakdown of blood brain barrier is induced by the peroxidative substance from the cisternal subarachnoid clots which has the vasospastic activity.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002439:Cefotaxime / Q000031:analogs & derivatives* / Q000134:cerebrospinal fluid / Q000627:therapeutic use; D015310:Cefotiam; D004322:Drainage; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000134:cerebrospinal fluid* / Q000601:surgery; D002546:Ischemic Attack, Transient / Q000517:prevention & control; D007700:Kinetics; D008297:Male; D008581:Meningitis / Q000517:prevention & control; D008875:Middle Aged; D012422:Rupture, Spontaneous
D015310:Cefotiam; D002439:Cefotaxime