[Adequate intrathecal diffusion of teicoplanin after failure of vancomycin, administered in continuous infusion in three cases of shunt associated meningitis].

Abstract

Glycopeptides which have excellent in vitro activity against the Gram-positive causal agents of meningitis unfortunately have a poor CSF penetration. Vancomycin distribution into CSF is improved when administered by a continuous intravenous route and staphylococcal shunt related infection have been reported to be cured. Teicoplanin has good in vitro activity against a lot of staphylococci, and activity superior to vancomycin, against streptococci and is less toxic. In three children with shunt ventriculitis (S epidermidis 2, S. faecalis 1) despite a continuous infusion, vancomycin 15 mg/kg over 60 minutes onset, then 50 mg/kg/day was clinically and bacteriologically ineffective with very poor CSF levels even if high blood levels. After failure of vancomycin we used teicoplanin as a continuous i.v. infusion 6 mg/kg over 60 mn onset, then 12 mg/kg/day. This treatment was quickly effective and well tolerated.

• Authors: C Jourdan, J Convert, A Peloux, O Boussaid, J Grando, S Tigaud
• Journal: Pathologie-biologie (Pathol Biol (Paris)) Vol. 44 Issue 5 Pg. 389-92 (May 1996) ISSN: 0369-8114 [Print] France
• Vernacular Title: Diffusion intrathécale efficace de la teicoplanine aprés échec de la vancomycine, administrées en perfusion continue, dans trois cas de méningite sur shunt.
• PMID: 8758482 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Teicoplanin
• Vancomycin

Topics

• Adolescent
• Anti-Bacterial Agents (administration & dosage, blood, cerebrospinal fluid, therapeutic use)
• Child
• Child, Preschool
• Drug Therapy, Combination (administration & dosage, therapeutic use)
• Female
• Humans
• Infusions, Intravenous
• Male
• Meningitis, Bacterial (drug therapy, microbiology)
• Staphylococcal Infections (drug therapy, microbiology)
• Staphylococcus (isolation & purification)
• Staphylococcus epidermidis (isolation & purification)
• Teicoplanin (administration & dosage, blood, cerebrospinal fluid, therapeutic use)
• Treatment Failure
• Vancomycin (administration & dosage, blood, cerebrospinal fluid, therapeutic use)