title: Conventional- versus high-dose vancomycin regimen in patients with acute bacterial meningitis: a randomized clinical trial.
abstract: OBJECTIVE
  Efficacy of the conventional- versus high-dose vancomycin regimen in patients with acute bacterial meningitis was compared.
  
  
  METHODS
  In a randomized clinical trial 44 patients with acute bacterial meningitis were randomly assigned to the conventional- or high-dose vancomycin groups. Clinical and laboratory parameters were used for evaluation of response to the treatment regimens.
  
  
  RESULTS
  In the high-dose group, leukocytosis and fever resolved significantly faster than those in the conventional group. Furthermore, the length of hospitalization was shorter and Glasgow Coma Scale at the end of 10th day was significantly lower in the high dose compared to the conventional group. Trend of creatinine clearance changes did not differ significantly between the two groups.
  
  
  CONCLUSIONS
  In comparison to the conventional-dose regimen, the high-dose vancomycin regimen was associated with significantly more favorable clinical response without increase in the incidence of nephrotoxicity in patients with acute bacterial meningitis.
authors.affiliation: Mashhad University of Medical Sciences, Department of Clinical Pharmacy, Faculty of Pharmacy , Mashhad , Iran.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Elyasi
authors.forename: Hossein
authors.initials: H
authors.lastname: Khalili
authors.forename: Simin
authors.initials: S
authors.lastname: Dashti-Khavidaki
authors.forename: Hamid
authors.initials: H
authors.lastname: Emadi-Koochak
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D016920:Meningitis, Bacterial / Q000188:drug therapy*; D008875:Middle Aged; D014640:Vancomycin / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: bacterial meningitis; clinical response; nephrotoxicity; vancomycin