Cefoperazone : blood and csf levels in patients with inflamed and uninflamed haematoencephalic barrier

The major advantages of cefoperazone (CEP), a new third-generation cephalosporin, are its in vitro activity against Pseudomonas aeruginosa and other Gram-negative organisms and the very high blood levels it attains after both i.m. and i.v. administration in the usual dosages. From a neurological standpoint these properties are most important, in view of the increasing incidence of Gram-negative meningitis and the considerable toxicity of the aminoglycosides. Using a microbiological method, cefoperazone concentrations were investigated in the cerebrospinal fluid (CSF) of subjects with 'normal' (uninflamed) heamatoencephalic barrier (HEB) and patients with inflamed HEB. CSF samples were obtained at various times after i.v. administration of CEP. The values found range from 0.1 to 0.4 mcg/ml in patients with normal HEB and from 1.0 to 1.2 in those with inflamed HEB. These results indicate that there is increased penetration of CEP through inflamed HEB and that a good concentration of the drug is maintained in the CSF.