Pharmacokinetics of intraventricularly administered teicoplanin in Staphylococci ventriculitis

Following craniotomy for a medulloblastoma in the posterior cranial fossa, a 6-year old girl developed a ventriculitis with coagulase negative staphyl ococci associated with the use of a ventriculostomy. Treatment with intrave nous (iv) and intraventricular (ivt) vancomycin resulted in negative cultur es of the cerebrospinal fluid, but had to be stopped because of a severe al lergic skin reaction. Teicoplanin was administered iv (240 mg once daily) a nd ivt (10 mg once daily), resulting in high teicoplanin CSF levels that we re used to model the pharmacokinetics of ivt teicoplanin in this patient. N o signs of recurrent infection or adverse events occurred. It is concluded that a pharmacokinetic model can be derived from this case that can be used as prior to guide teicoplanin intraventricular therapy in other patients.