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Abstract
Vancomycin (VM) is used as empirical therapy for bacterial meningitis (BM). We investigated the relationship of the microbiological efficacy of VM for BM with VM minimum inhibitory concentration (MICVM), serum VM trough concentration (VMser) and cerebrospinal fluid (CSF) protein (P)/serum albumin (SA) ratio, which may reflect the extent of blood–brain barrier (BBB) disruption. Twelve BM patients were enrolled and VM was microbiologically effective in seven (58.3%). VMser, MICVM, and CSF-P/SA ratio were not associated with the microbiological efficacy of VM. The microbiological efficacy of VM was significantly associated with CSF-P/SA ratio multiplied by VMser relative to the MICVM (η = 0.61, p = 0.04). These results indicate that the parameter combining VMser, MICVM, and the extent of BBB disruption could be associated with the microbiological efficacy of VM in BM patients.
Acknowledgement
The authors thank the neurology and neurosurgery staff of Chiba University Hospital for their assistance in this work.
Statement ethics
Ethical approval was obtained from the medical research ethics committee at Chiba University (No. 2743). The information disclosure document is available on the Chiba University Hospital website. Patients were notified about their participation in the study and informed that they were free to opt out.
Disclosure statement
No potential conflict of interest was reported by the authors.
Author contributions
All authors meet the ICMJE authorship criteria. MI and MU contributed to the implementation of the research and the analysis of the results. YS and YK checked the statistical analysis and provided statistical advice. SY, TS, YI, and II interpreted the data. All authors contributed to writing the final manuscript.