Penetration of Sulbactam into Cerebrospinal Fluid of Patients with Viral Meningitis or without Meningitis

In a study designed to determine the penetration of sulbactam into the central nervous system, a single intramuscular dose of 0.5-1.0 g was given to 19 patients: nine with viral meningitis and 10 with normal cerebrospinal fluid (CSF). Drug levels in CSF were first detectable 2 hr after administration in patients with viral meningitis and 4 hr after administration in patients with normal CSF. The sulbactam levels were low (0-3.7 mg/ml), and no significant differences were found between levels in the two groups of patients. For the achievement of therapeutic concentrations of sulbactam in CSF, doses larger than those administered in this study should be used in conjunction with a beta-lactam antibiotic.