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Vancomycin for treating cerebrospinal fluid shunt infections in pediatric patients

Jill B Thompson1, Stephanie Einhaus, Steve Buckingham

  • 1Department of Pharmacy, The University of Tennessee Health Science Center and Le Bonheur Children's Medical Center, Memphis, Tennessee.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|November 3, 2012
PubMed

Insights

Vancomycin is crucial for treating pediatric cerebrospinal fluid (CSF) shunt infections, often caused by Staphylococcus and Streptococcus. Monitoring CSF vancomycin levels is essential for effective treatment and preventing complications.

Area of Science:

  • Pediatric Infectious Diseases
  • Neurosurgery
  • Pharmacology

Background:

  • Cerebrospinal fluid (CSF) shunt infection is a primary cause of shunt failure.
  • Infections can lead to severe neurological complications including intellectual impairment and death.
  • Prompt treatment is critical to prevent adverse outcomes.

Purpose of the Study:

  • To review the existing literature on vancomycin use for pediatric CSF shunt infections.
  • To provide guidance on vancomycin dosing and monitoring in this patient population.

Main Methods:

  • Literature review of published studies on vancomycin for pediatric CSF shunt infections.
  • Analysis of infection timing, causative organisms, and treatment strategies.

Main Results:

  • CSF shunt infections commonly occur within 6 months of placement or revision.
  • Staphylococcus and Streptococcus species are the predominant pathogens.
  • Methicillin-resistant staphylococci necessitate vancomycin as the preferred antibiotic.

Conclusions:

  • Vancomycin is the antibiotic of choice for pediatric CSF shunt infections, particularly those caused by resistant staphylococci.
  • Intravenous vancomycin (60 mg/kg/day) and intraventricular administration (starting at 10 mg/day) are recommended.
  • Therapeutic drug monitoring of CSF vancomycin concentrations (target trough: 5-20 mg/L) is crucial for optimizing treatment efficacy and safety.

Keywords:
cerebrospinal fluidpediatricshunt infectionsvancomycinventriculoperitoneal

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