Minimal Cerebrospinal Concentration of Miltefosine Despite Therapeutic Plasma Levels During the Treatment of Amebic Encephalitis.

Minimal Cerebrospinal Concentration of Miltefosine Despite Therapeutic Plasma Levels During the Treatment of Amebic Encephalitis. Antimicrob Agents Chemother. 2019 Nov 04;: Authors: Monogue ML, Watson D, Alexander JS, Cavuoti D, Doyle LM, Wang MZ, Prokesch BC Abstract Miltefosine is an alkylphosphocholine compound used primarily for treatment of leishmaniasis that also demonstrates in vitro and in vivo anti-amebic activity against Acanthamoeba species. As such, recommendations for treatment of amebic encephalitis generally include miltefosine therapy. Data supports a minimum amebicidal concentration of at least 16 mcg/mL is required for most Acanthamoeba species. Although there is a high level of mortality associated with amebic encephalitis, a paucity of data regarding miltefosine levels in the plasma and cerebrospinal fluid in vivo exists in the literature. We found that despite aggressive dosing (miltefosine 50 mg orally every 6 hours) and therapeutic plasma levels, cerebrospinal fluid miltefosine concentration was negligible in a patient with Acquired Immunodeficiency Syndrome (AIDS) and Acanthamoeba encephalitis. PMID: 31685474 [PubMed - as supplied by publisher]
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research

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