1401. Minimal Cerebrospinal Concentration of Miltefosine Despite Therapeutic Plasma Levels during the Treatment of Amebic Encephalitis

摘要

BackgroundMiltefosine is an alkylphosphocholine compound used primarily for the 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 support a minimum amebicidal concentration (MAC) of at least 16 μg/mL is required for most Acanthamoeba species. Given the high mortality associated with amebic encephalitis and a paucity of data regarding miltefosine levels in the plasma and cerebrospinal fluid (CSF) in vivo, we sought to determine whether a patient being treated with oral miltefosine at a higher-than-recommended dose obtained therapeutic plasma and CSF concentrations.