Exploration of Vancomycin Concentrations in Cerebrospinal Fluid and Plasma after Craniocerebral Surgery

Abstract

Patients who underwent cranial hematoma removal, extra-ventricular drainage, intracranial arteriovenous malformation resection, and other craniotomy procedures and were administered vancomycin were selected. Cerebrospinal fluid (CSF) and plasma specimens were collected simultaneously from patients at different time points using the random number method, and vancomycin concentrations in CSF and plasma were determined by enzyme amplification immunoassay. The ratio of vancomycin in CSF to plasma concentration was calculated, and the medical records were analyzed to initially investigate the relevant factors that can affect the drug concentration or blood-brain barrier. The mean plasma concentration of vancomycin was 11.87±8.5μg/mL, the CSF concentration was 2.42±1.34μg/mL, and the cerebral blood ratio was 0.28±0.21. This study suggests that the transmission rate of vancomycin did not increase significantly after craniocerebral surgery; due to individual differences, CSF and plasma concentrations vary greatly, and drug concentration monitoring is recommended.