Antibiotic therapy in the treatment of bacterial infections of the small animal central nervous system
Keywords:
Antibiotic therapy, CNS bacterial infection, blood-brain-barrier, veterinary neurologyAbstract
Although infections in the central nervous system are less common than infections in other organics systems, they can cause life-threatening consequences and are a challenge for small animal practitioners. Among the factors that make these infections difficult to treat are the fact that it is surrounded by the blood-brain barrier, that hinders penetration of many substances, and the difficulty of obtaining positive results when trying to isolate the causative agent through spinal tap. This article aims to describe the blood-brain barrier, the most common antimicrobials used to treat bacterial infections in the central nervous system and their main applications in small animal practice. In the veterinary literature, trimethoprim, sulfonamides, chloramphenicol, and metronidazole are cited as antimicrobials with excellent penetration on the blood-brain barrier; oxacillin, penicillin’s, ceftriaxone, moxalactam, tetracyclines and carbenicillin with intermediate penetration; and aminoglycosides, first-generation cephalosporins, and clindamycin with little penetration. It was concluded that knowing the blood-brain barrier characteristics, pharmacokinetics and pharmacodynamics of antimicrobial agents, along with the main etiological agents, are the key to choose the most appropriate antibiotic to be applied in each individual case. It is noticed that in the veterinary literature there are few reports describing aspects of pharmacokinetics and pharmacodynamics in feline and canine species, requiring more studies in this area.
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