Exploring the Factors Affecting the Transferability of Vancomycin to Cerebrospinal Fluid in Postoperative Neurosurgical Patients with Bacterial Meningitis

Naoki Ichinose, Kozue Shinoda, Gakushi Yoshikawa, Eri Fukao, Yuki Enoki, Kazuaki Taguchi, Toshimi Oda, Kazuo Tsutsumi, Kazuaki Matsumoto

Research output: Contribution to journalArticlepeer-review

Abstract

Vancomycin (VCM) is a standard treatment for bacterial meningitis. However, little is known about the transferability of VCM to cerebrospinal fluid (CSF), thus evidence of the transferability of VCM to CSF during bacterial meningitis is needed. In this study, we evaluated the concentration of VCM in the plasma and CSF of postoperative neurosurgical patients with bacterial meningitis and evaluated the factors that affect the transferability of VCM to CSF. The concentrations of VCM in plasma (trough) and CSF were determined in eight patients (four males and four females) with bacterial meningitis who were treated with VCM using HPLC. The ratio of the VCM concentrations in CSF/plasma was also calculated by estimating the blood VCM concentration at the same time as the VCM concentration in CSF was measured. The results showed that the VCM concentration in CSF was 0.9-12.7 µg/mL and the CSF/plasma VCM concentration ratio was 0.02-0.62. We examined the effect of drainage on the transferability of VCM to CSF, which showed that the VCM concentration in CSF and the CSF/plasma VCM concentration ratio were significantly higher in patients not undergoing drainage than in patients who were undergoing drainage. The CSF protein and glucose concentrations, which are diagnostic indicators of meningitis, were positively correlated with the VCM concentration in CSF and the CSF/plasma VCM concentration ratio. Thus, VCM transferability to CSF may be affected by changes in the status of the blood-brain barrier and blood-cerebrospinal fluid barrier due to drainage or meningitis.

Original languageEnglish
Pages (from-to)1398-1402
Number of pages5
JournalBiological & pharmaceutical bulletin
Volume45
Issue number9
DOIs
Publication statusPublished - 2022

Keywords

  • cerebrospinal fluid
  • meningitis
  • vancomycin

ASJC Scopus subject areas

  • Pharmacology
  • Pharmaceutical Science

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