Ventriculitis in neurocritical care patients leads to significant morbidity and mortality. Antibiotic dose optimization targeting pharmacokinetic/pharmacodynamic (PK/PD) exposures associated with improved bacterial killing may improve therapeutic outcomes. We sought to develop and apply a population PK model in infected critically ill patients to determine optimal piperacillin-tazobactam (PTZ) dosing regimens to achieve target cerebrospinal fluid (CSF) exposures. Neurosurgical patients with external ventricular drains and receiving PTZ treatment were recruited and had plasma and CSF samples collected and assayed. A population PK model was developed using plasma and CSF piperacillin and tazobactam concentrations. Eight patients were recruited. Median age was 59 years, median weight was 70 kg, and five patients were female. The median creatinine clearance was 84 mL/min/1.73 m (range 52-163). Substantial inter-individual PK variability was apparent, particularly in CSF. Piperacillin penetration into CSF had a median of 3.73% (range 0.73%-7.66%), and tazobactam CSF penetration was not predictable. Dosing recommendations to optimize CSF exposures for the treatment of ventriculitis were not possible due to substantial PK variability and very low drug penetration. High plasma PTZ exposures may not translate to effective exposures in CSF.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1128/aac.00601-24 | DOI Listing |
Hum Cell
December 2024
Department of Integrated Traditional Chinese and Western Medicine, Xiangya Hospital, Central South University, Jiangxi Hospital, National Reginal Center for Neurological Disease, Honggutan District, No.266 Fenghe North Avenue, Nanchang, 330038, Jiangxi, China.
Acute injury and secondary injury caused by traumatic brain injury (TBI) seriously threaten the health of patients. The purpose of this study was to investigate the role of β-Asarone in TBI-induced neuroinflammation and injury. In this work, the effects of β-Asarone on nerve injury and neuronal apoptosis were investigated in mice with TBI by controlled cortical impingement.
View Article and Find Full Text PDFCurr Microbiol
December 2024
Department of Virus Research, Manipal Institute of Virology, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
Acute encephalitis syndrome (AES) presents with the onset of fever, altered sensorium and/or seizures, known to be caused by various infectious and non-infectious aetiological agents, among which viruses are the commonest. The severity of AES prompts rapid diagnosis, which is not met by time-consuming conventional diagnostic techniques. In this study, archived cerebrospinal fluid samples of laboratory-confirmed viral AES, an acute infectious condition and Guillain-Barré Syndrome (GBS), a post-infectious, autoimmune condition was assessed for soluble membrane attack complex (sMAC) using ELISA.
View Article and Find Full Text PDFAm J Physiol Regul Integr Comp Physiol
December 2024
Integrative and Biomedical Physiology, The Pennsylvania State University, University Park, PA, USA.
High-density lipoprotein (HDL) oxylipins regulate inflammation, and acute systemic inflammation can precipitate cognitive impairment. Females have more HDL and stronger immune responses than males, yet higher dementia risk. Little is known about sex differences in oxylipin responses to inflammatory stimuli and potential crosstalk between acute systemic inflammation and central oxylipin signaling in either sex.
View Article and Find Full Text PDFLaryngoscope
December 2024
Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand.
Objectives: To investigate the characteristics of the vascular pedicle of the nasoseptal flap (NSF) and its perfusion patterns using intraoperative indocyanine green (ICG) angiography during endoscopic skull base surgery (ESBS), and examine the correlation between ICG perfusion patterns and clinical outcomes, including postoperative cerebrospinal fluid (CSF) leak and flap necrosis.
Methods: This study enrolled patients undergoing ESBS between January 2017 and December 2021. Intraoperative ICG angiography was performed to visualize the arterial supply of the nasal septum and evaluate NSF perfusion.
Clin Park Relat Disord
November 2024
Department of Neurology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Introduction: Creutzfeldt-Jakob disease (CJD) is a rare, rapidly progressive, fatal, neurodegenerative disease classified as prion diseases. There are many subtypes of this disease, but information about clinical presentation and investigation findings in Thailand is scarce.
Objective: To describe the clinical presentation, radiological and electroencephalographic characteristics of CJD encountered at Siriraj hospital in the past 10 years (between January 1, 2006 and December 31, 2015).
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!