Plasma and Cerebrospinal Fluid Population Pharmacokinetics of Vancomycin in Patients with External Ventricular Drain
Zhendong Chen, Max Taubert, Chunli Chen, Charalambos Dokos, Uwe Fuhr, Thomas Weig, Michael Zöller, Suzette Heck, Konstantinos Dimitriadis, Nicole A. Terpolilli, Christina Kinast, Christina Scharf, Constantin Lier, Christoph Dorn, Uwe Liebchen
Abstract
. There was no detectable difference between the data for sampling from the proximal and the distal port. Intermittent infusion and continuous infusion with a loading dose reached the CSF target concentration faster than continuous infusion only. All infusion schedules reached similar CSF trough concentrations. Beyond adjusting doses according to renal function, starting treatment with a loading dose in patients with primary CSF infection is recommended. Occasionally, very high and possibly toxic doses would be required to achieve adequate CSF concentrations, which calls for more investigation of direct intraventricular administration of vancomycin. (This study has been registered at ClinicalTrials.gov under registration no. NCT04426383).