Cerebrospinal fluid concentrations of antituberculosis agents in adults and children

摘要: Summary Tuberculous meningitis (TBM) causes a devastating morbidity and mortality in adults children. Even patients presenting at an early stage of disease, deterioration may occur despite apparently adequate therapy. The literature relating to cerebrospinal fluid penetration antituberculosis agents is reviewed. Amongst the essential isoniazid has best CSF pharmacokinetics reaching peak concentrations ( C max ) only slightly less than blood. Pyrazinamide also good children receiving dosages 40 mg/kg exceeds proposed minimal inhibitory concentration 20 μg/ml. Streptomycin other aminoglycosides ethambutol have poor cannot be first choice for TBM treatment. Rifampicin used seldom reaches exceeding MIC, but does so more frequently when up 20 mg/kg are used. non-essential ethionamide, fluoroquinolones, with exception ciprofloxacin, cycloserine (terizadone) relatively recommended treatment INH 10 mg/kg (range 6–15 mg/kg bodyweight), rifampicin 15 mg/kg 10–20 mg/kg), pyrazinamide 35 mg/kg 30–40 mg/kg), 15–25 mg/kg) streptomycin 12–18 mg/kg). second-line ofloxacin, levofloxacin moxifloxacin should 15–20 mg/kg, ethionamide single dose, if tolerated, 15 mg/kg. Antituberculous chemotherapy started as soon diagnosis considered.