Abstract:
OBJECTIVE:The purpose of the study was to investigate the pharmacokinetics of combined intravenous (i.v.) and intracerebroventricular (i.c.v.) vancomycin for patients with intracranial infections after craniotomy and to provide the basis for establishing the intracranial local administration criterion. METHODS:Fourteen postoperative intracranial infection cases with surgical cavity/ventricular drainages were given vancomycin (1.0 g, i.v. drip for 2 hours, quaque 12 h, and a simultaneous i.c.v. injection of 10 mg). Their blood and cerebral spinal fluid (CSF) specimens were collected at each time point before and after administrations. The concentrations and biochemical properties were measured. RESULTS:The 1-hour serum vancomycin concentration reached a peak of 46.38 ± 33.39 mg/L; the trough concentration of 48 hours was 8.10 ± 7.11 mg/L; the CSF vancomycin concentration reached a peak of 382.17 ± 421.00 mg/L at 0.25 hours, and the 48-hour trough concentration was 30.82 ± 29.53 mg/L. The inhibitory quotient was calculated at 15.4 by the minimum inhibitory concentration 2 mg/L of target bacteria and had reached the range of 10 to 20 recommended by Infectious Diseases Society of America guidelines. The pH value and osmotic pressure of CSF were found to have no significant changes before and after administration. There was no increasement of seizures and ototoxicity in our study. Before the drug administration and 1 week later, the changes of creatine had no statistically significant, with P > .05. CONCLUSIONS:The combined i.v. and i.c.v. administration may improve CSF vancomycin concentrations without side effects at the same dosage. Our finding suggests that it can be an option for the treatment of severe intracranial infections after craniotomy; however, its safety and effectiveness need to be confirmed by further large-scale studies.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Chen K,Wu Y,Wang Q,Wang J,Li X,Zhao Z,Zhou Jdoi
10.1016/j.jcrc.2014.09.020subject
Has Abstractpub_date
2015-02-01 00:00:00pages
218.e1-5issue
1eissn
0883-9441issn
1557-8615pii
S0883-9441(14)00403-1journal_volume
30pub_type
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更新日期:2015-08-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
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更新日期:2006-03-01 00:00:00
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更新日期:2015-02-01 00:00:00
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更新日期:2012-04-01 00:00:00
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更新日期:1999-09-01 00:00:00
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更新日期:2005-12-01 00:00:00
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