Volume 11, Issue 1 (3-2023)
JoMMID 2023, 11(1): 60-61 |
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Department of Infectious Diseases, Aster Malabar Institute of Medical Sciences, Calicut, India
Abstract: (808 Views)
Beta-lactam antibiotics are traditionally not considered for intrathecal therapy, despite their poor penetration into the cerebrospinal fluid (CSF) during intravenous therapy, because target concentrations of the beta-lactam antibiotic in the central nervous system can usually be achieved with a higher intravenous dose [1]. However, in cases where inadequate clinical response is seen even with maximal doses of intravenous antibiotics, and when access for intraventricular administration of antibiotics is available, this route can be utilized for patient management, as we report now. Cefepime at high doses has been reported to cause seizures and encephalopathy [2]. However, therapeutic intraventricular administration of cefepime for the management of nosocomial meningitis, leading to successful microbiological clearance has not been reported previously in the literature.
Type of Study: Letter to the Editor |
Subject:
Anti-microbial agents, resistance and treatment protocols
Received: 2022/12/14 | Accepted: 2023/02/28 | Published: 2023/05/20
Received: 2022/12/14 | Accepted: 2023/02/28 | Published: 2023/05/20
References
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2. Reza M, Bagert B, Reese G, Reeves MA. Cefepime-induced Neurotoxicity in the Critically Ill: A Modifiable Risk Factor (P7-12.001). Neurology. 2022; 98 (18 Supplement).
3. Pacifici GM, Marchini G. Clinical Pharmacology of Cefepime in Infants and Children. Int J Pediatr. 2017; 5 (4): 4723-40.
4. Durand-Maugard C, Lemaire-Hurtel AS, Gras-Champel V, Hary L, Maizel J, Prud'homme-Bernardy A, et al. Blood and CSF monitoring of cefepime-induced neurotoxicity: nine case reports. J Antimicrob Chemother. 2012; 67 (5): 1297-9. [DOI:10.1093/jac/dks012]
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