Does zosyn or unasyn have better cns penetration? Do you need higher doses?

Comment by InpharmD Researcher

The CNS penetration of piperacillin/tazobactam (Zosyn®) and ampicillin/sulbactam (Unasyn®) have not been directly compared; however, their CSF penetration appears to be comparable. High doses of ampicillin/sulbactam (16 g/8 g day) are reported to be effective in treating Acinetobacter meningitis, while an older study reported successful treatment of gram-negative meningitis with piperacillin (324 to 436 mg/kg/day). However, results from the older study may not be applicable in the modern setting.

Background

A 2010 review of penetration of different antimicrobials to blood-cerebrospinal fluid/blood-brain barrier (BBB) noted different factors, such as molecular sizes, lipophilicity, plasma protein binding, and active transporters, may affect central nervous system (CNS) penetrations. In the absence of meningeal inflammation, the penetration of beta-lactams is relatively poor. If a high level of activity against susceptible pathogens is confirmed, the daily intravenous (IV) dose of ampicillin can be increased to ≥ 15 g for adults with normal renal function. Among different beta-lactamase inhibitors (e.g., sulbactam and tazobactam), sulbactam was reported with broad clinical experience for CNS infections. High-dose sulbactam (up to 8 g/day) plus ampicillin (16 g/day) had been used successfully to treat Acinetobacter meningitis. In vitro susceptibility testing suggested that larger than standard doses of β-lactamase inhibitors may be necessary to treat CNS infections. Overall, the ideal agent to treat CNS infections should be small, moderately lipophilic, have a low level of plasma protein binding, and have not a strong ligand of P-gp or another efflux pump at the BBB. [1], [2]

An older study from 1981 observed the use of piperacillin in four patients with gram-negative meningitis. Piperacillin was dosed at 324 to 436 mg/kg/day, which resulted in a cerebrospinal fluid level of 23 mcg/mL at 24 hours. Therefore, the mean penetration was determined to be 32% and was deemed adequate for treatment. However, results from older studies are difficult to extrapolate to the current healthcare landscape. [3]

An online textbook on Critical Care (from the authors of EMCrit) states both ampicillin/sulbactam and piperacillin/tazobactam have a 1% entry into uninflamed meninges. However, in inflamed meninges, piperacillin/tazobactam has a 30% meningeal penetration compared to 20% with ampicillin/sulbactam. [4]

A recent review discussing the challenges of managing healthcare-associated ventriculitis and meningitis suggested that many commonly used drug classes, including beta-lactams and glycopeptides, hardly penetrate the cerebrospinal fluid (CSF) and thus may not achieve the therapeutic levels. In the presence of resistant pathogens, higher daily doses and prolonged or continuous administration may be considered to facilitate pathogens clearance. Alternatively, intraventricular antibiotic therapy in addition to IV therapy can be used; however, due to the increased risk of aseptic meningitis and seizures, patients should be treated with caution. The authors do not specifically discuss the roles of piperacillin/tazobactam versus ampicillin/sulbactam in this case. [5]

References:

[1] Nau R, Sörgel F, Eiffert H. Penetration of drugs through the blood-cerebrospinal fluid/blood-brain barrier for treatment of central nervous system infections. Clin Microbiol Rev. 2010;23(4):858-883. doi:10.1128/CMR.00007-10
[2] Cawley MJ, Suh C, Lee S, Ackerman BH. Nontraditional dosing of ampicillin-sulbactam for multidrug-resistant Acinetobacter baumannii meningitis. Pharmacotherapy. 2002;22(4):527-532. doi:10.1592/phco.22.7.527.33676
[3] Dickinson GM, Droller DG, Greenman RL, Hoffman TA. Clinical evaluation of piperacillin with observations on penetrability into cerebrospinal fluid. Antimicrob Agents Chemother. 1981;20(4):481-486. doi:10.1128/AAC.20.4.481
[4] Farkas, J. The Internet Book of Critical Care. Antibiotics. Published June 24, 2021. https://emcrit.org/ibcc/antibiotics/
[5] Karvouniaris M, Brotis A, Tsiakos K, Palli E, Koulenti D. Current Perspectives on the Diagnosis and Management of Healthcare-Associated Ventriculitis and Meningitis. Infect Drug Resist. 2022;15:697-721. Published 2022 Feb 28. doi:10.2147/IDR.S326456

Relevant Prescribing Information

Distribution of piperacillin and tazobactam into cerebrospinal fluid is low in subjects with non-inflamed meninges, as with other penicillins. [6]

Penetration of both ampicillin and sulbactam into cerebrospinal fluid in the presence of inflamed meninges has been demonstrated after IV administration of Unasyn. [7]

References:

[6] Piperacillin and tazobactam injection. Prescribing information. Sandoz Inc; 2021.
[7] UNASYN (ampicillin sodium and sulbactam sodium injection). Prescribing information. Roerig; 2021.

Literature Review

A search of the published medical literature revealed 2 studies investigating the researchable question:

Does zosyn or unasyn have better cns penetration? Do you need higher doses?

Please see Tables 1-2 for your response.


 

Cerebrospinal Fluid Penetration of Different Antibiotics
Medication Uninflamed or mildly inflamed meninges (AUCCSF/AUCS) Strong meningeal inflammation (AUCCSF/AUCS) Relationship of CSF concentration to MIC with usual doses Notes
Penicillins (in general) 0.02 0.2 CSF concentration with uninflamed meninges close to the MICs for moderately susceptible bacteria Low toxicity; daily dose can be increased up to 15–20 g of ampicillin
Ampicillin N/A N/A
Piperacillin 0.034 0.32
Beta-lactamase inhibitors (in general) 0.07 0.1 CSF concentration with inflamed and uninflamed meninges below the concentration used in vitro for susceptibility testing (1–4 mg/liter) Little experience with in vivo activity in meningitis in humans; high-dose sulbactam (up to 8 g/day) was used successfully to treat Acinetobacter meningitis
Sulbactam N/A N/A
Tazobactam 0.106 N/A
AUC: area under the curve; CSF: cerebrospinal fluid; MIC: minimum inhibitory concentration; S: systemic

 

References:

Adapted from: Nau R, Sörgel F, Eiffert H. Penetration of drugs through the blood-cerebrospinal fluid/blood-brain barrier for treatment of central nervous system infections. Clin Microbiol Rev. 2010;23(4):858-883. doi:10.1128/CMR.00007-10

 

Cerebrospinal Fluid Penetration of Different Antibiotics*
Medication CSF:Plasma AUC ratio CSF concentrations (mg/L) Timing of CSF sampling post-dose Drug dose used in the study
Ampicillin Not available 0.35-0.70 1 hour 33 mg/kg
Not available 0.35-0.54 2 hours
Not available 0.70 4 hours
Piperacillin 0.018-0.124 <0.37-8.67 Various 6.5 g x1 (with tazobactam)
  0.32 23 24 hours 324-426 mg/kg/day as continuous infusion
  0.20 24 48-72 hours
Tazobactam 0.030-0.739 Not available Various 6.5 g x1 dose (with piperacillin)
AUC: area under the curve; CSF: cerebrospinal fluid
*Sulbactam was not included

 

References:

Adapted from: Kearney BP, Aweeka FT. The penetration of anti-infectives into the central nervous system. Neurol Clin. 1999;17(4):883-900. doi:10.1016/s0733-8619(05)70171-7