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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Strenger, V; Farowski, F; Müller, C; Hofer, N; Dornbusch, HJ; Sperl, D; Lackner, H; Benesch, M; Urban, C.
Low penetration of caspofungin into cerebrospinal fluid following intravenous administration of standard doses.
Int J Antimicrob Agents. 2017; 50(2):272-275 Doi: 10.1016/j.ijantimicag.2017.02.024
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Führende Autor*innen der Med Uni Graz
Strenger Volker
Co-Autor*innen der Med Uni Graz
Benesch Martin
Dornbusch Hans Jürgen
Hofer Nora
Lackner Herwig
Sperl Daniela Ingrid
Urban Ernst-Christian
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Abstract:
The kinetics of caspofungin (CAS) in cerebrospinal fluid (CSF) following intravenous (i.v.) administration has been studied exclusively in animal models. Human data are missing so far. In this study, 13 CSF samples were obtained at different time points following i.v. infusion of CAS in ten paediatric haemato-/oncological patients (age range 1.0-14.2 years, median 8.6 years) without signs of central nervous system (CNS) infection (n = 10 samples) or with infectious meningitis (n = 3 samples). Serum samples were obtained concurrently. Liquid chromatography-tandem mass spectrometry was used for CAS quantification. Whilst CAS serum levels were in the expected range, varying between 0.6 and 20.3 µg/mL (median 7.0 µg/mL), 11 of 13 CSF levels were below the limit of detection of 0.084 µg/mL at 3.0-48.0 h (median 23.3 h) following i.v. infusion. Only two (of three) levels in patients with bacterial meningitis were above the limit of detection (0.3 µg/mL and 0.09 µg/mL, respectively). These results indicate the low capacity of CAS to penetrate into the CNS even in inflamed meninges. Monotherapy with standard doses of CAS appears not to be suitable for treatment of fungal CNS infections. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing)
Administration, Intravenous -
Adolescent -
Antifungal Agents - administration & dosage
Antifungal Agents - pharmacokinetics
Caspofungin -
Cerebrospinal Fluid - chemistry
Child -
Child, Preschool -
Chromatography, Liquid -
Echinocandins - administration & dosage
Echinocandins - pharmacokinetics
Female -
Humans -
Infant -
Lipopeptides - administration & dosage
Lipopeptides - pharmacokinetics
Male -
Prospective Studies -
Serum - chemistry
Tandem Mass Spectrometry -
Time Factors -

Find related publications in this database (Keywords)
Echinocandin
Caspofungin
Blood-brain barrier
Invasive fungal infection
CNS infection
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