The Blood–Brain Barrier and Pharmacokinetic/Pharmacodynamic Optimization of Antibiotics for the Treatment of Central Nervous System Infections in Adults

Nicholas Haddad, Maddie Carr, Steve Balian, James Lannin, Yuri Kim, Courtney Toth, Jennifer Jarvis

Research output: Contribution to journalReview articlepeer-review

Abstract

Bacterial central nervous system (CNS) infections are serious and carry significant morbidity and mortality. They encompass many syndromes, the most common being meningitis, which may occur spontaneously or as a consequence of neurosurgical procedures. Many classes of antimicrobials are in clinical use for therapy of CNS infections, some with established roles and indications, others with experimental reporting based on case studies or small series. This review delves into the specifics of the commonly utilized antibacterial agents, updating their therapeutic use in CNS infections from the pharmacokinetic and pharmacodynamic perspectives, with a focus on the optimization of dosing and route of administration that have been described to achieve good clinical outcomes. We also provide a concise synopsis regarding the most focused, clinically relevant information as pertains to each class and subclass of antimicrobial therapeutics. CNS infection morbidity and mortality remain high, and aggressive management is critical in ensuring favorable patient outcomes while averting toxicity and upholding patient safety.

Original languageEnglish
Article number1843
JournalAntibiotics
Volume11
Issue number12
DOIs
StatePublished - Dec 2022

Keywords

  • antibiotic
  • antimicrobial
  • blood–brain barrier
  • brain abscess
  • central nervous system infections
  • meningitis
  • pharmacodynamics
  • pharmacokinetics
  • the specific classes and names of antimicrobial agents discussed in the review
  • ventriculitis

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