{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T15:50:15Z","timestamp":1793375415034,"version":"4.5.0"},"reference-count":221,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T00:00:00Z","timestamp":1671408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Bacterial central nervous system (CNS) infections are serious and carry significant morbidity and mortality. They encompass many syndromes, the most common being meningitis, which may occur spontaneously or as a consequence of neurosurgical procedures. Many classes of antimicrobials are in clinical use for therapy of CNS infections, some with established roles and indications, others with experimental reporting based on case studies or small series. This review delves into the specifics of the commonly utilized antibacterial agents, updating their therapeutic use in CNS infections from the pharmacokinetic and pharmacodynamic perspectives, with a focus on the optimization of dosing and route of administration that have been described to achieve good clinical outcomes. We also provide a concise synopsis regarding the most focused, clinically relevant information as pertains to each class and subclass of antimicrobial therapeutics. CNS infection morbidity and mortality remain high, and aggressive management is critical in ensuring favorable patient outcomes while averting toxicity and upholding patient safety.<\/jats:p>","DOI":"10.3390\/antibiotics11121843","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T05:55:43Z","timestamp":1671429343000},"page":"1843","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["The Blood\u2013Brain Barrier and Pharmacokinetic\/Pharmacodynamic Optimization of Antibiotics for the Treatment of Central Nervous System Infections in Adults"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1131-4238","authenticated-orcid":false,"given":"Nicholas","family":"Haddad","sequence":"first","affiliation":[{"name":"College of Medicine, Central Michigan University (CMU), Mt Pleasant, MI 48859, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddie","family":"Carr","sequence":"additional","affiliation":[{"name":"Covenant HealthCare, Saginaw, MI 48602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8149-8530","authenticated-orcid":false,"given":"Steve","family":"Balian","sequence":"additional","affiliation":[{"name":"CMU Medical Education Partners, Saginaw, MI 48602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Lannin","sequence":"additional","affiliation":[{"name":"Covenant HealthCare, Saginaw, MI 48602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Kim","sequence":"additional","affiliation":[{"name":"CMU Medical Education Partners, Saginaw, MI 48602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Toth","sequence":"additional","affiliation":[{"name":"Ascension St. Mary\u2019s Hospital, Saginaw, MI 48601, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Jarvis","sequence":"additional","affiliation":[{"name":"Ascension St. Mary\u2019s Hospital, Saginaw, MI 48601, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6028","DOI":"10.1038\/s41598-021-85382-4","article-title":"A hospital-based study on etiology and prognosis of bacterial meningitis in adults","volume":"11","author":"Sunwoo","year":"2021","journal-title":"Sci. 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