Norvancomycin is an
antibiotic that has been approved for the treatment of
infections caused by
antibiotic-resistant Gram-positive bacteria and has been used in China for more than a decade. However, the cerebrospinal fluid (CSF) penetration of
norvancomycin has not been evaluated. The aims of the study were (i) to investigate the pharmacokinetics and CSF penetration of
norvancomycin in
meningitis and non-
meningitis patients and (ii) to recommend favourable dosing regimens in
meningitis patients. Twenty adult patients (ten with
meningitis and ten without
meningitis) requiring
norvancomycin treatment were enrolled. All patients received a
norvancomycin regimen of 800 mg every 12 h. Blood and CSF samples were consecutively collected up to 12 h after the end of the fourth 60-min infusion.
Norvancomycin concentrations both in serum and CSF were measured using a high-performance liquid chromatography (HPLC) assay. CSF penetration of
norvancomycin was evaluated by calculating the CSF/serum ratio. Mean
norvancomycin serum trough levels were 9.9 ± 1.44 µg/mL in patients with
meningitis and 10.08 ± 1.12 µg/mL in patients without
meningitis (P > 0.05). In addition,
norvancomycin penetrated into the inflamed meninges, with mean CSF concentrations of 3.93-10.52 µg/mL and mean CSF/serum ratios of 0.18-0.43, both of which were significantly higher than in patients without
meningitis (P <0.05). These results suggest that
norvancomycin has higher CSF penetration in patients with
meningitis compared with other groups and that
norvancomycin is effective in treating patients with purulent
meningitis at a comparably low dose.