Penetration of Cefamandole into Spinal Fluid

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Abstract
Twelve patients, aged 6 months to 62 years, with proven bacterial meningitis, were given a single intravenous dose of cefamandole (33 mg/kg) 75 to 140 min before a routine lumbar puncture. Infecting organisms included Haemophilus influenzae (eight cases), Streptococcus pneumoniae (two cases), and Neisseria meningitidis and β-hemolytic streptococcus (one each). Cerebrospinal fluid (CSF) was analyzed by microbiological assay for cefamandole. The median concentration was 0.60 μg/ml, ranging from undetectable to 7.4 μg/ml. CSF cefamandole concentrations correlated with CSF protein: in six patients with CSF protein less than 100 μg/dl, the range of drug concentration was 0 to 0.62 μg/ml; and in six patients with CSF protein above 100 mg/dl, the range was 0.57 to 7.4 μg/ml. No significant correlation was noted between severity of illness, type of organism involved, or patient age and concentration of drug achieved.