Comparison of effect of administration of vancomycin by continuous infusion versus intermittent infusion on concentration of vancomycin in the CSF in postneurosurgical meningitis patients

Aim of study: Determine an appropriate therapeutic regimen for postneurosurgical meningitis patients in order to achieve desired vancomycin concentration in CSF. Study design: random; without placebo; single center; Method: Population of study: patients with postneurosurgical meningitis; Inclusion criteria: Patients who diagnosed postneurosurgical meningitis and received vancomycin; Age>18 years old; Exclusion criteria: Chronic kidney disease (creatinine clearance<50 mL/min) before initiate threatment; Occurring of acute kidney disease (according to the AKIN); Administration of intrathecal vancomycin; Through level<15mcg/mL; Through level>30mcg/mL; Sample volume: 20 patient Intervention: infusion of high dose of vancomycin in two methods: intermittent infusion and continuous infusion; Time of intervention: 21 days; from start of treatment till end of it; Result: vancomycin concentration in CSF; vancomycin concentration in serum; treatment efficacy. Method: 20 patients distribute in two equal groups randomly. In one group, at first, 10 patients will receive loading dose of 30 mg/kg then maintenance dose of 25 mg/kg twice daily by intermittent infusion. In another group, at first, 10 patients will receive loading dose of 30 mg/kg then maintenance dose of 50 mg/kg by continuous infusion. In addition, both groups will receive meropenem (2g IV TDS) and dexamethasone (10 mg IV QID) as conventional treatment.

Shahid Beheshti University of Medical Sciences