Pharmakokinetik von Moxifloxacin in Serum und Liquor cerebrospinalis bei neurologischen Intensivpatienten

Mahmoud Aiad
2016 unpublished
Moxifloxacin, a fluoroquinolone of group IV, has in vitro activity against a broad spectrum of Gram-positive and Gram-negative pathogens and in addition it is bactericidal. Especially, it has a strong affinity against Gram-positive bacteria such as pneumococci, streptococci, enterococci and especially staphylococci. Particularly because of its high lipophilicity, the gyrase inhibitor is characterized for penetration into the subarachnoid space and in the central nervous system (CNS) as well.The
more » ... purpose of this diploma thesis was the determination of important pharmacokinetic parameters of moxifloxacin in serum and cerebrospinal fluid (CSF) in neurological intensive care (ICU) patients with external ventriculostomy for continuous CSF flow caused by impaired CSF flow because of hydrocephalus after aneurysmal subarachnoid hemorrhage (SAH). In addition, moxifloxacin could be a therapeutic alternative in the nosocomial, drain associated ventricular meningitis. However, under the condition that moxifloxacin penetrates well into the cerebrospinal fluid compartment and having sufficient drug levels above the minimum inhibitory concentration of the corresponding species. Ten mechanically ventilated ICU patients and obligatory of catecholamine (seven women, three men) with SAH and necessity of the system of an external ventricular drainage (EVD) were included in this unicentric, prospective, open-label study. In all patients there was the indication for antibiotic therapy for verified pneumonia. Moxifloxacin was administered intravenously at the recommended dose of 400 mg once daily for a period of at least five days. Paired serum (blood from lying arterial cannula) and CSF samples were taken immediately before infusion, and 1, 1.5, 3, 6, 9, 12, 18 and 24 hours after administration for five consecutive days and were stored at -80 ° C till the determination of the concentrations. The concentrations of moxifloxacin were determined by a validated HPLC method. Moxifloxacin was well tolerated by all patients. The pharmacokineti [...]
doi:10.25365/thesis.43087 fatcat:2os5a4tnong3he7uvs33amoefe