Penetration of Ceftaroline Into Cerebrospinal Fluid(CSF)

Study Overview
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Brief Summary
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Ceftaroline is a piece of new cephalosporin very active on resistant staphylococci in methicillin (SEMR: Staphylococcus Epidermidis Resistant in Methicillin, SMAR: Staphylococcus Aureus Resistant in Methicillin)and/or in vancomycin ; Ceftaroline is also very active on pneumococci resistant in penicillin and/or 3rd generation of cephalosporins. Ceftaroline was approved by the European Medicines Agency for the treatment of complicated skin and soft tissue infections and community-acquired pneumonia. Scientific literature describes a good efficiency in septicemy and/or SAMR endocarditis. Besides, a study on animal shows the efficiency of ceftaroline in meningeal infections with gram-negative Bacilli. The rationale of this study is based on the antibacterial spectra of ceftaroline that could be used for the antibacterial treatment (curative and prophylactic) of CSF shunt associated infections. To validate this hypothesis, it is necessary to evaluate the concentration of ceftaroline in meningeal compartment after treatment.

Official Title
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Open and Exploratory Trial to Investigate the Pharmacokinetic of Ceftaroline in Patients With CSF Device

Conditions
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Meningitis, Ventriculitis

Intervention / Treatment
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* Drug: Ceftaroline fosamil


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients (≥ 18 years) Provision of informed consent prior to any study specific procedures Female patients of childbearing potential may be entered if pregnancy testing is negative and the patient agrees to abstain from procreational sexual intercourse or must use double-barrier contraceptive measures for the duration of the study Presence of an indwelling external cerebrospinal fluid (CSF) access device (ventriculostomy or lumbar drain) Presence of inflamed meninges as a result of documented or suspected meningitis or ventriculitis. Patients with both clinical symptoms (fever, headache, meningismus, and altered mentation) and laboratory parameters (CSF leukocytosis, defined as a CSF white blood cell count [WBC] of >10 3, elevated CSF protein, defined as CSF protein of >1g/l, reduced CSF glucose, defined as CSF glucose of <0.3g/l, or a positive CSF Gram stain or culture) indicative of CNS infection were deemed to have definitive bacterial meningitis/ventriculitis. Inflamed meninges were defined as the presence of >5 leukocytes/mm3 of CSF. Exclusion Criteria: Patient has documented history of hypersensitivity or allergic reaction (urticaria, angiooedema, anaphylaxis, desquamative rash) to any β-lactam antimicrobial including cephalosporins (contraindication to cephalosporins) Patient is pregnant or lactating and intends to continue breastfeeding Severe renal insufficiency defined as creatinine clearance < 50 mL/min. Patients with conditions known or suspected to alter pharmacokinetics (i.e., burn or cystic fibrosis patients) Refusal to participate Person not affiliated with the social security

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ceftaroline fosamil<br>600mg 1 hour intravenous infusion ZINFORO | Drug: Ceftaroline fosamil<br>* 600mg IV infusion<br>* Other names: ZINFORO;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ceftaroline serum concentration |  | before infusion, at 0.5h, 1h, 3h, 6h, 12h, 24h after infusion | 
| Ceftaroline cerebrospinal fluid concentration |  | before infusion, at 0.5h, 1h, 3h, 6h, 12h, 24h after infusion |