Minimal Cerebrospinal Fluid Concentration of Miltefosine despite Therapeutic Plasma Levels during the Treatment of Amebic Encephalitis

Marguerite L. Monogue, Durward Watson, Julie S. Alexander, Dominick Cavuoti, Laura M. Doyle, Michael Zhuo Wang, Bonnie C. Prokesch

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Miltefosine is an alkylphosphocholine compound that is used primarily for treatment of leishmaniasis and demonstrates in vitro and in vivo antiamebic activity against Acanthamoeba species. Recommendations for treatment of amebic encephalitis generally include miltefosine therapy. Data indicate that treatment with an amebicidal concentration of at least 16 μg/ml of miltefosine 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 plasma and cerebrospinal fluid in vivo exists in the literature. We found that despite aggressive dosing (oral miltefosine 50 mg every 6 h) and therapeutic plasma levels, the miltefosine concentration in cerebrospinal fluid was negligible in a patient with AIDS and Acanthamoeba encephalitis.

Original languageEnglish (US)
Article numbere01127-19
JournalAntimicrobial agents and chemotherapy
Volume64
Issue number1
DOIs
StatePublished - 2020

Keywords

  • AIDS
  • Ameba
  • Cerebrospinal fluid
  • HIV
  • Miltefosine

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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