Antibiotics

Question 1

Discuss the use of cephalosporin in neurological infections

Answer 1

Coverage : predominantly gram positive
Solubility: low lipophilicity —> poor BBB penetration. Although third generation cephalosporins (cefotazime, cefovecin and cefpodoxime) are more lipophilic that allows them to cross more easily the BBB.
Mechanism of action : time dependant —> requires to keep the drug maintenance level above MIC.

Question 2

Discuss the use of fluoroquinolones in neurological infections

Answer 2

Coverage : primarily gram-negative aerobic infections.
Solubility : moderately lipophilic, low to moderate protein binding capacity, low molecular weight.

Question 3

Discuss the use of metronidazole in neurological infections

Answer 3

Usually used to treat anaerobic infections.
Able to reach high drugs level in the CNS.

Question 4

Discuss the use of TMS in neurological infections

Answer 4

Reaches therapeutic levels in the CNS
Broad spectrum bactericidal —> often used as first line.

Question 5

Discuss the use of ampicillin in neurological infections

Answer 5

Ampicillin usually have high level of VNS penetration despite the state of the BBB
Generally low CNS penetration for penicillins but can increase with meningeal infallation.