Cerebrospinal fluid penetration and pharmacokinetics of vancomycin administered by continuous infusion to mechanically ventilated patients in an intensive care unit

J Albanèse, M Léone, B Bruguerolle, M L Ayem, B Lacarelle, C Martin, J Albanèse, M Léone, B Bruguerolle, M L Ayem, B Lacarelle, C Martin

Abstract

Cerebrospinal fluid (CSF) penetration and the pharmacokinetics of vancomycin were studied after continuous infusion (50 to 60 mg/kg of body weight/day after a loading dose of 15 mg/kg) in 13 mechanically ventilated patients hospitalized in an intensive care unit. Seven patients were treated for a sensitive bacterial meningitis and the other six patients, who had a severe concomitant neurologic disease with intracranial hypertension, were treated for various infections. Vancomycin CSF penetration was significantly higher (P < 0.05) in the meningitis group (serum/CSF ratio, 48%) than in the other group (serum/CSF ratio, 18%). Vancomycin pharmacokinetic parameters did not differ from those obtained with conventional dosing. No adverse effect was observed, in particular with regard to renal function.

Figures

FIG. 1
FIG. 1
Plasma vancomycin levels after continuous infusion of the antibiotic was stopped. Vancomycin was administered for a mean duration of 13 ± 7 days at a dose of 62 ± 17 mg · kg−1 · day−1.

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