Cerebrospinal fluid penetration and pharmacokinetics of vancomycin administered by continuous infusion to mechanically ventilated patients in an intensive care unit

Cerebrospinal fluid (CSF) penetration and the pharmacokinetics of vancomyci n were studied after continuous infusion (50 to 60 mg/kg of body weight/day after a loading dose of 15 mg/kg) in 13 mechanically ventilated patients h ospitalized in an intensive care unit. Seven patients were treated for a se nsitive bacterial meningitis and the other six patients, who had a severe c oncomitant neurologic disease with intracranial hypertension, were treated for various infections. Vancomycin CSF penetration was significantly higher (P < 0.05) in the meningitis group (serum/CSF ratio, 48%) than in the othe r group (serum/CSF ratio, 18%). Vancomycin pharmacokinetic parameters did n ot differ from those obtained with conventional dosing. No adverse effect w as observed, in particular with regard to renal function.