Clinical value of cerebrospinal fluid and serum linezolid concentration monitoring guided treatment in intracranial infection

doi:10.3877/cma.j.issn.2096-1537.2020.03.010

Abstract

Abstract:

Objective

To monitor the cerebrospinal fluid (CSF) concentration of linezolid and its blood-brain barrier (BBB) penetration rate in patients with intracranial infection after neurosurgery.

Methods

A total of six patients admitted to the neurosurgical intensive care unit with post-neurosurgery infection between June 2019 and November 2019 were selected. The CSF and serum linezolid concentrations, routine CSF test, CSF biochemistry test, and general vital signs were continuously monitored to analyze the BBB permeability rate of linezolid.

Results

The serum and CSF trough concentrations of intravenous linezolid were (4.65±2.72) μg/ml and (3.78±1.53) μg/ml, respectively, at 0.5 h before linezolid administration. The maximum mean serum concentration was (12.53±3.79) μg/ml, while the maximum mean CSF concentration was (5.55±2.00) μg/ml at 2 h after initiation of linezolid administrations. Intravenous linezolid AUCCSF/AUCserum was approximately 45%. All patients treated with linezolid were cured of intracranial infection.

Conclusion

Intravenous linezolid has a satisfactory BBB penetration rate of about 45%, and it has a good clinical effect. After intravenous application of linezolid, CSF concentrations vary greatly between individuals, so clinical monitoring of CSF concentrations is recommended for guiding its application.

Key words: Linezolid, Intracranial infection, Cerebrospinal fluid, Drug concentrations, Blood-brain barrier

Jian Sun, Mingchao Fan, Nian Wang, Jialin Sun, Aiwen Zhang, Wei Fang. Clinical value of cerebrospinal fluid and serum linezolid concentration monitoring guided treatment in intracranial infection[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2020, 06(03): 292-295.

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URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2020.03.010

https://icu.cma-cmc.com.cn/EN/Y2020/V06/I03/292

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References 14

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编号		用药前0.5 h	用药后
编号		用药前0.5 h	0.5 h	1.0 h	2.0 h	4.0 h	8.0 h
患者1
	血清	7.20	9.05	6.50	12.70	13.70	8.20
	脑脊液	5.10	4.21	4.15	4.18	5.95	3.93
患者2
	血清	7.25	6.05	15.40	17.7	16.90	11.35
	脑脊液	4.57	6.10	5.45	7.10	7.75	5.70
患者3
	血清	3.25	4.25	9.06	6.15	5.85	2.83
	脑脊液	4.32	5.50	6.88	6.12	7.20	4.86
患者4
	血清	2.80	3.12	10.00	8.17	7.94	7.56
	脑脊液	2.26	2.56	2.87	3.83	4.31	2.03
患者5
	血清	0.83	4.54	8.80	7.30	6.56	3.08
	脑脊液	2.31	2.10	2.88	3.10	3.80	2.27
患者6
	血清	6.58	8.30	15.90	14.60	12.60	7.46
	脑脊液	4.98	4.80	5.38	3.97	5.81	3.67

编号		用药前0.5 h	用药后
编号		用药前0.5 h	0.5 h	1.0 h	2.0 h	4.0 h	8.0 h
患者1
	血清	7.20	9.05	6.50	12.70	13.70	8.20
	脑脊液	5.10	4.21	4.15	4.18	5.95	3.93
患者2
	血清	7.25	6.05	15.40	17.7	16.90	11.35
	脑脊液	4.57	6.10	5.45	7.10	7.75	5.70
患者3
	血清	3.25	4.25	9.06	6.15	5.85	2.83
	脑脊液	4.32	5.50	6.88	6.12	7.20	4.86
患者4
	血清	2.80	3.12	10.00	8.17	7.94	7.56
	脑脊液	2.26	2.56	2.87	3.83	4.31	2.03
患者5
	血清	0.83	4.54	8.80	7.30	6.56	3.08
	脑脊液	2.31	2.10	2.88	3.10	3.80	2.27
患者6
	血清	6.58	8.30	15.90	14.60	12.60	7.46
	脑脊液	4.98	4.80	5.38	3.97	5.81	3.67

患者编号	谷浓度（μg/ml）		峰浓度（μg/ml）		AUC 0~12 h（μg•h/ml）		通透率
患者编号	血清	脑脊液	血清	脑脊液	血清	脑脊液	通透率
1	7.20	5.10	13.70	5.95	90.84	40.49	0.45
2	7.25	4.57	17.70	7.75	118.90	56.03	0.47
3	3.25	4.32	9.06	7.20	94.65	48.16	0.51
4	2.80	2.26	10.00	4.31	65.45	26.41	0.40
5	0.83	2.31	8.80	2.27	45.19	15.35	0.34
6	6.58	4.98	15.9	5.81	94.71	40.59	0.43
平均值	4.65	3.92	12.53	5.55	84.96	37.84	0.43
标准差	2.72	1.29	3.79	2.00	25.84	14.75	0.06

患者编号	谷浓度（μg/ml）		峰浓度（μg/ml）		AUC 0~12 h（μg•h/ml）		通透率
患者编号	血清	脑脊液	血清	脑脊液	血清	脑脊液	通透率
1	7.20	5.10	13.70	5.95	90.84	40.49	0.45
2	7.25	4.57	17.70	7.75	118.90	56.03	0.47
3	3.25	4.32	9.06	7.20	94.65	48.16	0.51
4	2.80	2.26	10.00	4.31	65.45	26.41	0.40
5	0.83	2.31	8.80	2.27	45.19	15.35	0.34
6	6.58	4.98	15.9	5.81	94.71	40.59	0.43
平均值	4.65	3.92	12.53	5.55	84.96	37.84	0.43
标准差	2.72	1.29	3.79	2.00	25.84	14.75	0.06

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