Abstract
Ceftizoxime (2x1 g or 2x2 g in drop infusion/24 hrs.) was administered for 2 weeks to 28 patients treated for disseminated Lyme borreliosis with peripheral or central nervous system impairment. The average serum concentration of ceftizoxime (dose 2x1 g/24 hrs.) detected by radial diffusion on agar plates was 4.57 mg/l and CSF concentration was 0.14 mg/l.
Ceftizoxime administered in a dose of 2x2 g/24 hrs. produced serum concentration 5.57 mg/l and CSF concentration 0.24 mg/l. The average values of ceftizoxime concentration exceeded the minimum inhibitory concentration of cephalosporins for borrelias, which are estimated to be between 0.04-0.06 mg/l.
CSF was abnormal in 29 samples out of 36 CSF samples. In 7 subjects with normal CSF finding the diagnosis of late disseminated borreliosis was proved.
Elevated protein and normal cell count mere found in 12 cases. In 13 samples elevated proteins and pleiocytosis were found.
In 4 CSF samples an isolated pleiocytosis was detected. Ceftizoxime concentration in CSF was measured in 29 samples.
Concentration over 0.04 mg/l was found in 22 cases. Ceftizoxime concentration under 0.04 mg/l was found in 7 samples.
Only in one case a completely normal CSF finding was proved. There was ceftizoxime concentration over 0.04 mg/l in 6 cases with normal CSF finding.
Ceftizoxime crossed the blood/CSF barrier even in 6 subjects with late disseminated neuroborreliosis and normal CSF without BCSF barrier impairment. In 14 samples of CSF with ceftizoxime over 0.1 g/l (64% of all CSF findings with ceftizoxime over 0.04 mg/l) the inflammatory formula in CSF was found in 80% of all cases (10x elevated proteins and cells, or vice versa and 1x pleiocytosis).