THE CONCENTRATIONS OF PENICILLINS IN THE CEREBROSPINAL FLUID AND BRAIN OF RABBITS WITH EXPERIMENTAL MENINGITIS

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Abstract
The selection of an antibiotic to treat purulent meningitis is based upon the minimal inhibitory concentration of the drug for the infecting organism and the concentration of the antibiotic in the blood and cerebrospinal fluid following systemic administration. Few antibiotics reach the cerebrospinal fluid of normal animals in appreciable concentrations. All reach higher levels in the presence of meningitis. Several semisynthetic penicillins possess novel properties suggesting that the drugs should be useful in the treatment of meningitis. The distribution of these drugs in the cerebrospinal fluid in meningitis is not known. Experiments were carried out in which the concentrations of nine semisynthetic penicillins were assayed in the blood, cerebrospinal fluid, and brain of rabbits with purulent meningitis. Appreciable concentrations of all penicillins were found in the cerebrospinal fluid. A correlation was shown between the levels reached in the cerebrospinal fluid and the amount of penicillin bound by plasma protein. Cerebrospinal fluid levels did not accurately reflect brain tissue concentrations.