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Antimicrobial Agents and Chemotherapy, August 1999, p. 1932-1934, Vol. 43, No. 8
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Bactericidal Activity of Vancomycin in Cerebrospinal Fluid

Markus Nagl,1,* Claudia Neher,2 Josef Hager,3 Bettina Pfausler,4 Erich Schmutzhard,4 and Franz Allerberger2

Federal Public Health Laboratory2 and Institute for Hygiene,1 Leopold-Franzens-University of Innsbruck, A-6010 Innsbruck, and Department of Surgery, Division of Pediatric Surgery,3 and Department of Neurology,4 University Hospital of Innsbruck, A-6020 Innsbruck, Austria

Received 25 January 1999/Returned for modification 1 March 1999/Accepted 3 June 1999

Intraventricular application of vancomycin is an effective therapeutic regimen for the treatment of shunt-associated staphylococcal ventriculitis. We examined the in vitro activity of vancomycin at high concentrations against Staphylococcus aureus ATCC 25923 and Staphylococcus epidermidis ATCC 12228 in human cerebrospinal fluid samples. Time-kill curves revealed equal efficacies for concentrations of 10, 100, and 300 µg/ml, and incubation times of 24 to 48 h were needed to achieve a 3 log10 reduction of viable bacteria. A concentration of 5 µg/ml showed a slightly lower activity, but this difference was not significant. In an infant who was successfully treated for shunt-associated ventriculitis due to S. epidermidis by once-daily local administration of vancomycin (3 mg for 2 days and 5 mg for 4 days [0.5 to 0.8 mg/kg of body weight]) the in vivo kill kinetics were similar to those for the in vitro results. These results support time-dose regimens that provide trough vancomycin levels of 5 to 10 µg/ml.

* Corresponding author. Mailing address: Institute for Hygiene, Leopold-Franzens-University, Fritz-Pregl-Str. 3, A-6010 Innsbruck, Austria. Phone: 43 512 507 3430. Fax: 43 512 507 2870. E-mail: waldemar.gottardi{at}uibk.ac.at.

Antimicrobial Agents and Chemotherapy, August 1999, p. 1932-1934, Vol. 43, No. 8
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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