A case report of treatment of a streptococcal brain abscess with ceftobiprole supported by the measurement of drug levels in the cerebrospinal fluid
Simone Giuliano,
Jacopo Angelini,
Sarah Flammini,
Paola Della Siega,
Eleonora Vania,
Luca Montanari,
Denise D'Elia,
Jessica Biasizzo,
Alberto Pagotto,
Carlo Tascini
Affiliations
Simone Giuliano
Infectious Diseases Division, Department of Medicine, University Hospital Friuli Centrale ASUFC, Udine, Italy
Jacopo Angelini
Clinical Pharmacology and Toxicology Institute, University Hospital Friuli Centrale ASUFC, 33100, Udine, Italy; Department of Medicine (DIME), University of Udine, Udine, Italy
Sarah Flammini
Infectious Diseases Division, Department of Medicine, University Hospital Friuli Centrale ASUFC, Udine, Italy
Paola Della Siega
Infectious Diseases Division, Department of Medicine, University Hospital Friuli Centrale ASUFC, Udine, Italy
Eleonora Vania
Infectious Diseases Division, Department of Medicine, University Hospital Friuli Centrale ASUFC, Udine, Italy
Luca Montanari
Infectious Diseases Division, Department of Medicine, University Hospital Friuli Centrale ASUFC, Udine, Italy
Denise D'Elia
Infectious Diseases Division, Department of Medicine, University Hospital Friuli Centrale ASUFC, Udine, Italy; Corresponding author. Denise D'Elia Infectious Diseases Division, Department of Medicine, University Hospital Friuli Centrale ASUFC, 33100 Udine, Italy.
Jessica Biasizzo
Clinical Pathology Division, Department of Laboratory Medicine, University Hospital Friuli Centrale ASUFC, Udine, Italy
Alberto Pagotto
Infectious Diseases Division, Department of Medicine, University Hospital Friuli Centrale ASUFC, Udine, Italy
Carlo Tascini
Infectious Diseases Division, Department of Medicine, University Hospital Friuli Centrale ASUFC, Udine, Italy
In this paper, we describe the case of a patient admitted to our hospital because of a brain abscess due to Streptococcus intermedius. The management of brain abscess is challenging given the limited potential drug options with effective penetration into both the central nervous system and the abscess capsule to achieve adequate therapeutic concentrations. Due to the high anti-streptococcal activity of ceftobiprole and the availability of ceftobiprole therapeutic drug monitoring in our hospital, we decided to treat the patient with ceftobiprole. To maximize the antimicrobial effect of ceftobiprole, we chose a prolonged intravenous infusion, and we monitored its concentrations in both plasma and cerebrospinal fluid.
