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.
Publication types
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Case Reports
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English Abstract
MeSH terms
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Adolescent
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Anti-Bacterial Agents / administration & dosage
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Anti-Bacterial Agents / blood
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Anti-Bacterial Agents / cerebrospinal fluid
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Anti-Bacterial Agents / therapeutic use*
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Child
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Child, Preschool
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Drug Therapy, Combination / administration & dosage
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Drug Therapy, Combination / therapeutic use
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Female
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Humans
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Infusions, Intravenous
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Male
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Meningitis, Bacterial / drug therapy*
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Meningitis, Bacterial / microbiology
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Staphylococcal Infections / drug therapy*
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Staphylococcal Infections / microbiology
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Staphylococcus / isolation & purification
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Staphylococcus epidermidis / isolation & purification
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Teicoplanin / administration & dosage
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Teicoplanin / blood
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Teicoplanin / cerebrospinal fluid
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Teicoplanin / therapeutic use*
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Treatment Failure
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Vancomycin / administration & dosage
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Vancomycin / blood
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Vancomycin / cerebrospinal fluid
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Vancomycin / therapeutic use*
Substances
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Anti-Bacterial Agents
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Teicoplanin
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Vancomycin