Penetration of Vancomycin to Cerebrospinal Fluid (CSF) in Childhood 93

Background: There are only scanty data on vancomycin(va) distribution to cerebrospinal fluid (CSF) in childhood. In order to characterize CSF distribution of va after intravenous administration, we prospectively investigated children with temporary external CSF-drainage. Subjects: In 7 children (age 1 month - 10 years), plasma and CSF-samples were taken simultaneously and va concentrations were measured(μg/ml; polarization fluorescence immunoassay; Abbott, Munich, F.R.G.).Interventions: Children were treated with i.v. va at doses in the range of 2 × 5 m/kg b.w. to 2 × 10 mg/kg b.w. per day, administered by within 60 minutes. Blood was drawn 1 h after the end of the infusions period, simultaneously CSF was aspirated from the drainage. Results: Median trough CSF va concentrations were 2.16μg/ml, mean corresponding plasma concentrations 2.72 μg/ml (n = 12 each), median peak CSF concentrations 2.5 μg/ml, median peak plasma concentrations 14.5 μg/ml (n = 4 each). All CSF cultures were sterile. Conclusion: Due to the outlined pharmacocinetic data, va may be considered for perioperative prophylaxis of CSF shunt infections.Table