Cerebrospinal fluid concentrations of quinupristin-dalfopristin in a patient with vancomycin-resistant Enterococcus faecalis ventriculitis

A 44-year-old man was treated successfully for vancomycin-resistant Enteroc occus faecium (VREF) ventriculitis with intrathecal quinupristin-dalfoprist in I mg, 2 mg, and 4 mg, and other intravenous antibiotics. Cerebrospinal f luid samples were collected before and after the 1-mg and 2-mg, doses to de termine the concentrations of quinupristin-dalfopristin and its active meta bolites. Concentrations were above the minimum inhibitory concentration for VREF immediately after unclamping the extraventricular drain and were quan tifiable for at least 7 hours.