Cerebrospinal fluid penetration of tigecycline

Abstract

Today very little is known about tigecycline penetration into cerebrospinal fluid (CSF). We report, in a clinical setting, tigecycline concentration, and the area under concentration-time curve (AUC) - both in blood and in CSF - of a patient affected by ventriculo-atrial shunt (VAS) infection due to Enterococcus faecium and Nocardia farcinica. At the steady state, the serum and CSF concentration of tigecycline, at through, were 49 ng/mL and 5.2 ng/mL respectively, whereas the peak concentrations were 203 ng/mL and 13.4 ng /mL, with an average ratio of CSF-to-serum concentrations (CSF/serum) of 0.079. The serum AUC0-12 value was 1361.5 h*ng/ml, the CSF AUC0-12 was 91.6 h*ng/ml and the ratio between CSF and serum AUC0-12 (CSF/serum AUC0-12) was 0.067. Despite the low tigecycline CSF concentration, the microbiological tests were all negative. Tigecycline weakly penetrates CSF.

Keywords

• tigecycline
• CSF
• pharmacokinetics