DOI: https://doi.org/10.15587/2313-8416.2015.47265

Comparative study of clindamycin concentration in the cerebrospinal fluid after intravenous and intrathecal administration in patients with toxoplasmic meningoencephalitis

Сергій Петрович Борщов

Abstract


Aim of the work: to study the difference of clindamycin concentration in CSF at the intravenous and combined (intrathecal + intravenous) ways of administration of preparation.

Materials and methods: study was carried out at the treatment of 11 HIV-positive patients 27-63 years old (men and women) with toxoplasmic meningoencephalitises.

There was measured the clindamycin concentration in CSF of every patient after intravenous and combined (intrathecal + intravenous) ways of administration of preparation. The determinations of concentration were done by the way of the reverse-phase high-performance liquid chromatography (HPLC) with ultraviolet (UV) detection. Statistic processing of the received data was carried out using the Wilcoxon criterion.

Results of research. There was received the statistically significant increase of clindamycin concentration in CSF of patients in a day after combined (intrathecal + intravenous) administration of preparation comparing with an intravenous administration.

Conclusions. 1. Intrathecal administration of 150 mg. of clindamycin with 8 mg. of dexamethasone is safe.

2. Intrathecal administration of 150 mg. of clindamycin with 8 mg. of dexamethasone in combination with an intravenous administration of preparation leads to statistically significant increase of clindamycin concentration in CSF at least during a day after injection.

3. Intrathecal administration of clindamycin with dexamethasone in offered doses can be recommended for treatment of meningoencephalitises that caused by microorganisms susceptible to clindamycin.

4. If the therapy of toxoplasmic meningoencephalitis was started with an intravenous prescription of clindamycin it is recommended an additional treatment with an intrathecal administration of clindamycin with dexamethasone in offered doses to increase efficiency by creating an effective concentration of preparation in the nidus of infection.

5. Intrathecal methods of therapy must be used by the specialists of the respective qualification. 


Keywords


toxoplasmic meningoencephalitis; clindamycin; intrathecal administration; cerebrospinal fluid (CSF); concentration; safety; efficiency.

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