title: Vancomycin for treating cerebrospinal fluid shunt infections in pediatric patients.
abstract: Infection is a major cause of CSF shunt failure that places the patient at risk of intellectual impairment, development of loculated CSF compartments, and death. The purpose of this article is to review the published literature related to vancomycin for treatment of pediatric CSF shunt infections. Fifty percent of shunt infections appear within 2 months of shunt placement or revision; 90% occur within 6 months. Ninety percent of organisms infecting CSF shunting devices are Staphylococcus and Streptococcus species. The emergence of methicillin-resistant strains of staphylococci has made vancomycin the antibiotic of choice for these infections. The usual intravenous regimen is 60 mg/kg/day divided every 6 hours. Intraventricular vancomycin should be considered for most patients, starting with 10 mg daily. CSF vancomycin concentrations should be monitored and dosing adjustments made as needed to maintain CSF trough vancomycin concentrations between 5 and 20 mg/L.
authors.affiliation: Department of Pharmacy, The University of Tennessee Health Science Center and Le Bonheur Children's Medical Center, Memphis, Tennessee.
authors.forename: Jill B
authors.initials: JB
authors.lastname: Thompson
authors.forename: Stephanie
authors.initials: S
authors.lastname: Einhaus
authors.forename: Steve
authors.initials: S
authors.lastname: Buckingham
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Phelps
keywords: cerebrospinal fluid; pediatric; shunt infections; vancomycin; ventriculoperitoneal