[Clinical analysis of vancomycin continuous intravenous infusion in the treatment of patients with central nervous system infections].

Abstract

This study retrospectively analyzed the clinical data of patients with central nervous system infections (CNSI) after neurosurgery in the Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, from September 2010 to September 2022. Based on vancomycin administration regimens, the patients were divided into the intermittent intravenous infusion (IIV) group and the continuous intravenous infusion (CIV) group. Hematological indices were evaluated before and after vancomycin therapy to compare short-term efficacy and safety between the two regimens.A total of 90 patients were included, including 50 patients in the IIV group [28 males and 22 females, aged (50.9±12.6) years] and 40 patients in the CIV group [29 males and 11 females, aged (54.5±13.3) years].The CIV group demonstrated significantly lower post-treatment neutrophil-to-lymphocyte ratio (NLR: 7.0±4.4 vs 9.2±4.8), systemic inflammatory response index (SIRI) (6.1±6.0 vs 9.9±8.2), and incidence of augmented renal clearance (ARC) [10.0% (4/40) vs 42.0% (21/50)] compared to the IIV group. Additionally, the CIV group achieved higher trough concentration target attainment rates [85.0% (34/40) vs 56.0% (28/50)] and superior short-term clinical efficacy [72.5% (29/40) vs 52.0% (26/50)]than those in the IIV group (P<0.05). No significant difference in nephrotoxicity was observed between the two groups after the treatment (P>0.05).Compared to IIV, CIV can improve trough concentration target attainment, reduced ARC incidence, and enhance therapeutic efficacy in CNSI patients, suggesting that CIV may be a more optimized administration strategy for CNSI management.