title: Linezolid cerebrospinal fluid concentration in central nervous system infection.
abstract: We report two cases of central nervous system infection due to methicillin-resistant Staphylococcus epidermidis treated with linezolid. The first case was a 72-year old woman with ventriculitis in the presence of intraventricular catheter: therapeutic effectiveness was documented clinically and microbiologically; serum and cerebrospinal fluid levels were measured after the first and fourth doses: trough linezolid concentrations in cerebrospinal fluid were 1.44 and 2.9 mg/L respectively, higher than the minimum inhibitory concentration (MIC). The second case was a 27-year old man with post-traumatic cerebral abscess; during 5 days linezolid was not found in his cerebrospinal fluid despite very high serum level peak, and the drug was not detectable in cerebral tissue surgically removed after 14 days of therapy. Linezolid may not reach therapeutic concentrations in cerebrospinal fluid, and, when possible, we suggest that drug levels be monitored.
authors.affiliation: U.O. Anestesia e Rianimazione, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy. pmalacarne@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Malacarne
authors.forename: B
authors.initials: B
authors.lastname: Viaggi
authors.forename: A
authors.initials: A
authors.lastname: DI Paolo
authors.forename: R
authors.initials: R
authors.lastname: Danesi
authors.forename: M
authors.initials: M
authors.lastname: Del Tacca
mesh_terms: D000081:Acetamides / Q000134:cerebrospinal fluid*; D000328:Adult; D000368:Aged; D001922:Brain Abscess / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D002552:Cerebral Ventricles; D016903:Drug Monitoring; D004660:Encephalitis / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069349:Linezolid; D008297:Male; D016106:Methicillin Resistance; D023303:Oxazolidinones / Q000134:cerebrospinal fluid*; D013203:Staphylococcal Infections / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D013212:Staphylococcus epidermidis
chemical_list: D000081:Acetamides; D023303:Oxazolidinones; D000069349:Linezolid