CEREBROSPINAL-FLUID PENETRATION OF AMIKACIN IN CHILDREN WITH COMMUNITY-ACQUIRED BACTERIAL-MENINGITIS

The penetration of amikacin into the cerebrospinal fluid (CSF) was stu died with 16 children (mean age, 1 gear and 9 months; range, 3 months to 8 years) with community-acquired bacterial meningitis. Amikacin was given intravenously at a dose of 7.5 mg/kg of body weight twice daily . CSF was collected on day 1, at the expected peak concentration of am ikacin in CSF. The mean (standard deviation) concentration of amikacin in CSF was 1.65 (1.6) mg/liter. Concentrations of amikacin in CSF cor related significantly with CSF glucose levels on admission. The mean c oncentrations of amikacin in CSF were 2.9, 1.1, and 0.20 mg/liter in p atients with CSF glucose levels of <1, 1 to 2, and >2 mmol/liter, resp ectively. Thus, amikacin penetrates the blood-brain barrier substantia lly in children with bacterial meningitis and achieves particularly hi gh concentrations when CSF glucose level is <1 mmol/liter on admission .