Cargando…

Efficacy of Vancomycin and Meropenem in Central Nervous System Infections in Children and Adults: Current Update

The current antimicrobial therapy of bacterial infections of the central nervous system (CNS) in adults and pediatric patients is faced with many pitfalls as the drugs have to reach necessary levels in serum and cross the blood-brain barrier. Furthermore, several studies report that different factor...

Descripción completa

Detalles Bibliográficos
Autores principales: Schneider, Franziska, Gessner, André, El-Najjar, Nahed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8868565/
https://www.ncbi.nlm.nih.gov/pubmed/35203776
http://dx.doi.org/10.3390/antibiotics11020173
_version_ 1784656297924231168
author Schneider, Franziska
Gessner, André
El-Najjar, Nahed
author_facet Schneider, Franziska
Gessner, André
El-Najjar, Nahed
author_sort Schneider, Franziska
collection PubMed
description The current antimicrobial therapy of bacterial infections of the central nervous system (CNS) in adults and pediatric patients is faced with many pitfalls as the drugs have to reach necessary levels in serum and cross the blood-brain barrier. Furthermore, several studies report that different factors such as the structure of the antimicrobial agent, the severity of disease, or the degree of inflammation play a significant role. Despite the available attempts to establish pharmacokinetic (PK) modeling to improve the required dosing regimen for adults and pediatric patients, conclusive recommendations for the best therapeutic strategies are still lacking. For instance, bacterial meningitis, the most common CNS infections, and ventriculitis, a severe complication of meningitis, are still associated with 10% and 30% mortality, respectively. Several studies report on the use of vancomycin and meropenem to manage meningitis and ventriculitis; therefore, this review aims to shed light on the current knowledge about their use in adults and pediatric patients. Consequently, studies published from 2015 until mid-July 2021 are included, and data about the study population, levels of drugs in serum and cerebrospinal fluid (CSF), and measured PK data in serum and CSF are provided. The overall aim is to provide the readers a recent reference that summarizes the pitfalls and success of the current therapy and emphasizes the importance of performing more studies to improve the clinical outcome of the current therapeutical approach.
format Online
Article
Text
id pubmed-8868565
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-88685652022-02-25 Efficacy of Vancomycin and Meropenem in Central Nervous System Infections in Children and Adults: Current Update Schneider, Franziska Gessner, André El-Najjar, Nahed Antibiotics (Basel) Review The current antimicrobial therapy of bacterial infections of the central nervous system (CNS) in adults and pediatric patients is faced with many pitfalls as the drugs have to reach necessary levels in serum and cross the blood-brain barrier. Furthermore, several studies report that different factors such as the structure of the antimicrobial agent, the severity of disease, or the degree of inflammation play a significant role. Despite the available attempts to establish pharmacokinetic (PK) modeling to improve the required dosing regimen for adults and pediatric patients, conclusive recommendations for the best therapeutic strategies are still lacking. For instance, bacterial meningitis, the most common CNS infections, and ventriculitis, a severe complication of meningitis, are still associated with 10% and 30% mortality, respectively. Several studies report on the use of vancomycin and meropenem to manage meningitis and ventriculitis; therefore, this review aims to shed light on the current knowledge about their use in adults and pediatric patients. Consequently, studies published from 2015 until mid-July 2021 are included, and data about the study population, levels of drugs in serum and cerebrospinal fluid (CSF), and measured PK data in serum and CSF are provided. The overall aim is to provide the readers a recent reference that summarizes the pitfalls and success of the current therapy and emphasizes the importance of performing more studies to improve the clinical outcome of the current therapeutical approach. MDPI 2022-01-28 /pmc/articles/PMC8868565/ /pubmed/35203776 http://dx.doi.org/10.3390/antibiotics11020173 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Schneider, Franziska
Gessner, André
El-Najjar, Nahed
Efficacy of Vancomycin and Meropenem in Central Nervous System Infections in Children and Adults: Current Update
title Efficacy of Vancomycin and Meropenem in Central Nervous System Infections in Children and Adults: Current Update
title_full Efficacy of Vancomycin and Meropenem in Central Nervous System Infections in Children and Adults: Current Update
title_fullStr Efficacy of Vancomycin and Meropenem in Central Nervous System Infections in Children and Adults: Current Update
title_full_unstemmed Efficacy of Vancomycin and Meropenem in Central Nervous System Infections in Children and Adults: Current Update
title_short Efficacy of Vancomycin and Meropenem in Central Nervous System Infections in Children and Adults: Current Update
title_sort efficacy of vancomycin and meropenem in central nervous system infections in children and adults: current update
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8868565/
https://www.ncbi.nlm.nih.gov/pubmed/35203776
http://dx.doi.org/10.3390/antibiotics11020173
work_keys_str_mv AT schneiderfranziska efficacyofvancomycinandmeropenemincentralnervoussysteminfectionsinchildrenandadultscurrentupdate
AT gessnerandre efficacyofvancomycinandmeropenemincentralnervoussysteminfectionsinchildrenandadultscurrentupdate
AT elnajjarnahed efficacyofvancomycinandmeropenemincentralnervoussysteminfectionsinchildrenandadultscurrentupdate