Evidence map›Paper›PMID 38323369›Full record

ArticleThe Journal of antimicrobial chemotherapy2024

Linezolid brain penetration in neurointensive care patients.

Arthur Hosmann, Miriam M Moser, Wisse van Os, Leon Gramms, Valentin Al Jalali, Maria Sanz Codina, Walter Plöchl, Constantin Lier, Frieder Kees, Christoph Dorn and 3 more

Erratum issuedOpen access · hybridAbstract read
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.7field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 2 countries.

Arthur HosmannDepartment of Neurosurgery, Medical University of Vienna, Vienna, Austria.ORCID 0000-0001-7396-4239
Miriam M MoserDepartment of Neurosurgery, Medical University of Vienna, Vienna, Austria.ORCID 0009-0007-5317-1881
Wisse van OsDepartment of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Leon GrammsDepartment of Neurosurgery, Medical University of Vienna, Vienna, Austria.
Valentin Al JalaliDepartment of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-9196-1936
Maria Sanz CodinaDepartment of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-1687-5296
Walter PlöchlDepartment of Anesthesia, General Intensive Care Medicine and Pain Management, Medical University of Vienna, Vienna, Austria.
Constantin LierInstitute of Pharmacy, University of Regensburg, Regensburg, Germany.
Frieder KeesDepartment of Pharmacology, University of Regensburg, Regensburg, Germany.
Christoph DornInstitute of Pharmacy, University of Regensburg, Regensburg, Germany.
Karl RösslerDepartment of Neurosurgery, Medical University of Vienna, Vienna, Austria.
Andrea ReinprechtDepartment of Neurosurgery, Medical University of Vienna, Vienna, Austria.
Markus ZeitlingerDepartment of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Medical University of Vienna · ATUniversity of Regensburg · DE

Funding

Oesterreichische Nationalbank
6 · The paper itself

Abstract

backgroundLinezolid exposure in critically ill patients is associated with high inter-individual variability, potentially resulting in subtherapeutic antibiotic exposure. Linezolid exhibits good penetration into the CSF, but its penetration into cerebral interstitial fluid (ISF) is unknown.

objectivesTo determine linezolid penetration into CSF and cerebral ISF of neurointensive care patients. PATIENTS AND

methodsFive neurocritical care patients received 600 mg of linezolid IV twice daily for treatment of extracerebral infections. At steady state, blood and CSF samples were collected from arterial and ventricular catheters, and microdialysate was obtained from a cerebral intraparenchymal probe.

resultsThe median fAUC0-24 was 57.6 (24.9-365) mg·h/L in plasma, 64.1 (43.5-306.1) mg·h/L in CSF, and 27.0 (10.7-217.6) mg·h/L in cerebral ISF. The median penetration ratio (fAUCbrain_or_CSF/fAUCplasma) was 0.5 (0.25-0.81) for cerebral ISF and 0.92 (0.79-1) for CSF. Cerebral ISF concentrations correlated well with plasma (R = 0.93, P < 0.001) and CSF levels (R = 0.93, P < 0.001).The median fAUC0-24/MIC ratio was ≥100 in plasma and CSF for MICs of ≤0.5 mg/L, and in cerebral ISF for MICs of ≤0.25 mg/L. The median fT>MIC was ≥80% of the dosing interval in CSF for MICs of ≤0.5 mg/L, and in plasma and cerebral ISF for MICs of ≤0.25 mg/L.

conclusionsLinezolid demonstrates a high degree of cerebral penetration, and brain concentrations correlate well with plasma and CSF levels. However, substantial variability in plasma levels, and thus cerebral concentrations, may result in subtherapeutic tissue concentrations in critically ill patients with standard dosing, necessitating therapeutic drug monitoring.

Indexed as

BrainCritical IllnessIsocyanatesAnti-Bacterial AgentsHumansLinezolidPlasmaAnti-Bacterial AgentsIsocyanatesLinezolidmethyl isocyanate

Identifiers

PMID38323369
PMCPMC10904716
OpenAlexW4391592435

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.