Cerebrospinal Fluid Penetration of Vancomycin During Continuous Infusion Therapy in Patients With Nosocomial Ventriculitis
| Autor: | João Paulo Telles, Felipe Francisco Tuon, Victoria Stadler Tasca Ribeiro, Carolina Hikari Yamada, Juliano Gasparetto, Juliette Cieslinski, Dayana Dos Santos Oliveira |
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| Rok vydání: | 2021 |
| Předmět: |
Pharmacology
Cross Infection medicine.medical_specialty Maintenance dose business.industry Area under the curve Renal function medicine.disease Gastroenterology Loading dose Anti-Bacterial Agents Cerebral Ventriculitis Intensive Care Units Vancomycin Internal medicine medicine Ventriculitis Humans Cerebrospinal fluid penetration Pharmacology (medical) business External ventricular drain medicine.drug |
| Zdroj: | Therapeutic Drug Monitoring. 43:807-811 |
| ISSN: | 0163-4356 |
| DOI: | 10.1097/ftd.0000000000000907 |
| Popis: | Background This study aimed to evaluate the utility of a commercial kit used to measure serum vancomycin concentrations to determine vancomycin concentrations in cerebrospinal fluid (CSF) samples and evaluate CSF penetration when administered as a continuous high-dose infusion in patients with nosocomial ventriculitis. Methods This study included patients with external ventricular drain infection who were admitted to the intensive care unit between January 2018 and September 2020. After validation, CSF samples from 33 patients were collected. All patients received 30 mg/kg of vancomycin as a loading dose followed by 60 mg/kg as a maintenance dose in continuous infusion; all CSF samples were collected at least 48 hours after the first dose. Results Thirty-three patients were enrolled in this study. The median serum creatinine level was 0.66 mg/dL (0.5-0.92; n = 30), and median creatinine clearance was 119.2 mL/min (64.6-138.4; n = 13). The median serum vancomycin 24-hour area under the curve (AUC24h) was 838 mg*h/L (515-1010). The median CSF vancomycin concentration was 5.20 mg/L (1.95-12.4). Median serum vancomycin concentration was 34.9 mg/L (21.47-42.1), and median CSF/serum ratio was 18.6% (8.4-41.5). Acute renal injury occurred in 21% (n = 7) of the patients by the end of the therapy. In addition, the vancomycin CSF/serum ratio was positively correlated with the median serum creatinine level (r = 0.670; P = 0.004). Conclusions Commercial vancomycin kits used to measure serum samples may be used to evaluate vancomycin concentrations in the CSF. Vancomycin penetration into CSF was 18.6%. |
| Databáze: | OpenAIRE |
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