Drug concentrations in the serum and cerebrospinal fluid of patients with intravenous drip of norvancomycin after neurosurgery procedure

Abstract:

ObjectiveTo understand the changing characteristics of drug concentration in the serum and cerebrospinal fluid(CSF) after intravenous (IV) drip of norvancomycin in patients after neurosurgery procedure. MethodsPatients with surgical cavity/ventricular drainages after neurosurgery procedure in a hospital in  2014 were selected, and they were divided into 2 groups according to the administration modes (12 in each group), conventional administration group: 0.8 g  norvancomycin IV drip for 60 minutes, repeated every 12 hours; continuous administration group, 0.8 g norvancomycin, IV drip for 60 minutes, followed by 0.4 g of IV drip for 11 hours, then 0.4 g for 12 hours, serum and CSF specimens were collected at different time points after administration, concentration of norvancomycin was determined. ResultsSerum norvancomycin concentration reached a peak of （55.52±26.04） and （59.22±41.88） mg/L in conventional administration group and continuous administration group respectively, 24hour serum concentration were （8.21±6.04） and （9.11±5.09）mg/L respectively；CSF norvancomycin concentration reached a peak of （16.31±11.15） and （8.82±8.91）mg/L in conventional administration group and continuous administration group respectively, 24hour CSF concentration were （6.12±2.34）and （5.71±4.72）mg/L respectively； CSF penetration rate of conventional administration group was calculated by ratio of area under curve (AUCCSF/AUCserum), at 0-12 and 12-24 h hour were 63.3% and 59.0% respectively；in continuous administration group were 25.4% and 47.4% respectively. According to 95% of the minimum inhibitory concentration (MIC90) 2 mg/L of target bacteria methicillinresistant Staphylococcus aureus (MRSA), AUC0-24/MIC90 in conventional administration group and continuous administration group were 192 and 184 respectively. ConclusionFor patients who receives early use of standard dose of norvancomycin after neurosurgery procedure, CSF drug concentration after convention and continuous administration of norvancomycin can both reach MIC90 against target bacteria.