Association Between Vancomycin Blood Brain Barrier Penetration and Clinical Response in Postsurgical Meningitis

Authors

  • Qing Wang The Second Xiangya Hospital of Central South University, Department of Pharmacy/Institute of Clinical Pharmacy, Changsha, Hunan, P.R. China.
  • Si Chen The Second hospital of Xiangxiang, Department of Pharmacy, Xiangtan, Hunan, P.R. China.
  • Yan-Gang Zhou The Second Xiangya Hospital of Central South University, Department of Pharmacy/Institute of Clinical Pharmacy, Changsha, Hunan, P.R. China.
  • Ping Xu The Second Xiangya Hospital of Central South University, Department of Pharmacy/Institute of Clinical Pharmacy, Changsha, Hunan, P.R. China.
  • Yi-Ping Liu The Second Xiangya Hospital of Central South University, Department of Pharmacy/Institute of Clinical Pharmacy, Changsha, Hunan, P.R. China.
  • Hua-Lin Cai The Second Xiangya Hospital of Central South University, Department of Pharmacy/Institute of Clinical Pharmacy, Changsha, Hunan, P.R. China.
  • Hong Chen The Second Xiangya Hospital of Central South University, Department of Neurosurgery, Changsha, Hunan, P.R. China.
  • Zheng Luo The Second Xiangya Hospital of Central South University, Department of Neurosurgery, Changsha, Hunan, P.R. China.
  • Hoan Linh Banh University of Alberta, Faculty of Medicine and Dentistry, Department of Family Medicine, Edmonton, AB, Canada.

DOI:

https://doi.org/10.18433/J3493F

Abstract

PURPOSE: This study investigated the association between vancomycin blood brain barrier penetration and clinical response in patients with postsurgical meningitis. METHODS: Adult patients with postsurgical meningitis were recruited. Eligible patients received vancomycin 500 mg every 6 h for at least 5 days. On day 3 or 4, cerebrospinal fluid (CSF) and simultaneous serum samples were obtained to determine CSF minimum concentrations (Cmin), serum Cmin and CSF to serum Cmin ratio. RESULTS: Twenty-two patients (14 men and 8 women; mean age of 52.6± 12.1 years) were recruited. The vancomycin Cmin was 3.63 ± 1.64 mg/L in CSF and 13.38 ± 5.36 mg/L in serum, with the CSF to serum Cmin ratio of 0.291 ± 0.118. The Cmin in serum and in CSF showed a significant correlation (p=0.005, r =0.575). The vancomycin CSF Cmin had a significant correlation with the decline of white blood cell counts (WBCs) in CSF (p=0.003, r =0.609). CSF Cmin, serum Cmin and CSF to serum Cmin ratio all showed no significant correlation with clinical response (p=0.335, 0.100, 0.679, respectively). CONCLUSIONS: There was a positive correlation between serum Cmin and CSF Cmin. However, only CSF Cmin is positively correlated with WBCs improvement in CSF. All other parameters such as serum Cmin, CSF Cmin and CSF to serum Cmin ratio had no correlation with clinical response.

 

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Published

2017-06-02

How to Cite

Wang, Q., Chen, S., Zhou, Y.-G., Xu, P., Liu, Y.-P., Cai, H.-L., … Banh, H. L. (2017). Association Between Vancomycin Blood Brain Barrier Penetration and Clinical Response in Postsurgical Meningitis. Journal of Pharmacy & Pharmaceutical Sciences, 20, 161–167. https://doi.org/10.18433/J3493F

Issue

Vol. 20 (2017): Pages 1-167

Section

Clinical Pharmacology and Therapeutics

License

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