Accumulation of vancomycin after intraventricular infusions

A 50-year-old man with an infected intracerebral hematoma was treated with daily intraventricular infusions containing 10 mg of vancomycin (half the dose suggested by others). A vancomycin level in the ventricular CSF of 606 micrograms/ml after nine days of therapy indicates a potential for accumulation of this drug in patients with extensive brain damage.