Primary Article

Vancomycin Penetration into CSF During Treatment of Patients Receiving Hemodialysis

Authors: CHARLES M. NOLAN MD, WILLIAM J. FLANIGAN MD, SHIVNANDA P. RASTOGI MD, TOM E. BREWER MD

Abstract

Penetration of vancomycin into CSF was determined during therapy with the regimens recently used to treat staphylococcal infections in patients receiving hemodialysis: 1 gm weekly or 750 mg twice weekly. During three episodes in two patients with proved or suspected central nervous system infection, CSF levels of vancomycin ranged from < 0.5 to 1.54μ,g/ml; in only two of six CSF specimens did the antibiotic level exceed its in vitro inhibitory concentration for the infecting organism. Thus, the vancomycin hemodialysis regimens may provide marginal to subtherapeutic CSF drug levels.

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References