Instillation of vancomycin into a cerebrospinal fluid reservoir to clear infection: Pharmacokinetic considerations

B. E. Hirsch, M. Amodio, A. I. Einzig, R. Halevy, R. Soeiro

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Vancomycin instilled in an Ommaya reservoir was used to treat a reservoir-associated infection. Vancomycin concentrations in cerebrospinal fluid (CSF) were measured, and derivation of pharmacokinetic parameters allowed tailoring of dosing. First-order kinetics were observed. The calculated half-life of 3.52 h was less than reported by others, and the apparent volume of distribution (60 ml) was less than anticipated. The elimination constant was 0.197 h-1. Empiric dosing based on schedules suggested in the literature would have led to high peak and low mean concentrations of intrareservoir vancomycin. Patients with reservoir-associated infections have a variety of pathophysiologic conditions that can result in alteration of normal CSF dynamics. Pharmacokinetic analysis is useful to individualize dosing and to optimize therapy with intrareservoir vancomycin.

Original languageEnglish (US)
Pages (from-to)197-200
Number of pages4
JournalJournal of Infectious Diseases
Volume163
Issue number1
DOIs
StatePublished - Jan 1 1991
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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