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Ganciclovir pharmacokinetic studies in the central nervous system (CNS) generally rely on single measurements in the cerebrospinal fluid (CSF) or homogenized brain tissue. Therefore the objective was to compare brain extracellular fluid (ECF) concentrations of ganciclovir with plasma and CSF concentrations in a porcine model, using microdialysis during a 24 h period. Six Danish landrace pigs (female, age 4 months, 31\u201337 kg) received two weight-adjusted intravenous doses of ganciclovir. Unbound ganciclovir concentrations were determined by microdialysis over 24 h in five compartments: CSF (lateral ventricle, cisterna magna, and lumbar) and brain ECF (cortical and subcortical). Data were compared with paired plasma samples. Ganciclovir concentrations &gt;IC\n              <jats:sub>50<\/jats:sub>\n              for CMV (1.6 \u00b5g\/mL) were achieved in all compartments. Concentrations &gt;IC\n              <jats:sub>90<\/jats:sub>\n              for CMV (8.3 \u00b5g\/mL) were only achieved in plasma and the lumbar CSF compartment. The concentration time curves indicated higher lumbar and cisternal CSF concentrations than ECF concentrations. The ECF compartments achieved greater maximum concentration (C\n              <jats:sub>max<\/jats:sub>\n              ), area under the concentration time curve (AUC), and time &gt;IC\n              <jats:sub>50<\/jats:sub>\n              after the second dose, and an accumulation ratio (R\n              <jats:sub>ac<\/jats:sub>\n              ) &gt;1. The greater C\n              <jats:sub>max<\/jats:sub>\n              , AUC, time &gt;IC\n              <jats:sub>50<\/jats:sub>\n              , and R\n              <jats:sub>ac<\/jats:sub>\n              &gt;1 in the ECF compartments with repeated dosages suggest that therapeutic concentrations may be achieved during long-term treatment. A higher loading dose might be warranted to improve early viral inhibition.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/aac.01815-24","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T13:48:03Z","timestamp":1742564883000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Distribution of ganciclovir in the porcine central nervous system"],"prefix":"10.1128","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1633-9582","authenticated-orcid":true,"given":"Johan Mikkel","family":"Guldb\u00e6k","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine, Aalborg University","place":["Aalborg, Denmark"]},{"name":"Department of Infectious Diseases, Aalborg University Hospital","place":["Aalborg, Denmark"]},{"name":"ESCMID Study Group for Infectious Diseases of the Brain (ESGIB)","place":["Basel, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8135-561X","authenticated-orcid":true,"given":"Theis","family":"Mariager","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aalborg University Hospital","place":["Aalborg, Denmark"]},{"name":"ESCMID Study Group for Infectious Diseases of the Brain (ESGIB)","place":["Basel, Switzerland"]},{"name":"Department of Neurosurgery, Aalborg University Hospital","place":["Aalborg, Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikkel Dreyer","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aalborg University Hospital","place":["Aalborg, Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob Holmen","family":"Terkelsen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aalborg University Hospital","place":["Aalborg, Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8316-995X","authenticated-orcid":true,"given":"Roland","family":"Nau","sequence":"additional","affiliation":[{"name":"ESCMID Study Group for Infectious Diseases of the Brain (ESGIB)","place":["Basel, Switzerland"]},{"name":"Institute of Neuropathology, University Medical Centre","place":["G\u00f6ttingen, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten Reidies","family":"Bjarkam","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aalborg University","place":["Aalborg, Denmark"]},{"name":"Department of Neurosurgery, Aalborg University Hospital","place":["Aalborg, Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aalborg University","place":["Aalborg, Denmark"]},{"name":"Department of Infectious Diseases, Aalborg University Hospital","place":["Aalborg, Denmark"]},{"name":"ESCMID Study Group for Infectious Diseases of the Brain (ESGIB)","place":["Basel, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Bodilsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aalborg University","place":["Aalborg, Denmark"]},{"name":"Department of Infectious Diseases, Aalborg University Hospital","place":["Aalborg, Denmark"]},{"name":"ESCMID Study Group for Infectious Diseases of the Brain (ESGIB)","place":["Basel, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00430-007-0066-x"},{"key":"e_1_3_4_3_2","first-page":"34","article-title":"Neurological complications in patients with HIV\/AIDS","volume":"2008","author":"Bolokadze N","year":"2008","unstructured":"Bolokadze N, Gabunia P, Ezugbaia M, Gatserelia L, Khechiashvili G. 2008. 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