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Nafcillin Concentration in Cerebrospinal Fluid During Treatment of Staphylococcal Infections
- JAMES G. KANE, M.D.;
- RICHARD H. PARKER, M.D.;
- GEORGE W. JORDAN, M.D.; and
- PAUL D. HOEPRICH, M.D.
Abstract
The nafcillin concentration of simultaneous cerebrospinal fluid (CSF) and serum specimens from nine patients being treated with parenteral nafcillin for staphylococcal infection were measured. Marked variations in the ratio of CSF/serum nafcillin concentration were observed. However, the concentration of nafcillin in the CSF was greater than the minimum lethal concentration (MLC) for Staphylococcus aureus in eight of the nine patients. In five patients with CSF pleocytosis, the nafcillin concentration was three to 100 times the MLC. These results support the recommendation to use nafcillin in doses of at least 100 to 200 mg/kg body weight · day for treatment of meningitis caused by S. aureus.
Article and Author Information
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▸From the Section of Infectious Diseases, Medical Service, Veterans Administration Hospital, Washington, D.C.; and the Section of Infectious and Immunologic Diseases, Department of Internal Medicine, School of Medicine, University of California at Davis.
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▸Requests for reprints should be addressed to Richard H. Parker, M.D.; Chief, Section of Infectious Diseases, Veterans Administration Hospital; 50 Irving Street, N.W.; Washington, DC 20422.
