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Conventional- versus high-dose vancomycin regimen in patients with acute bacterial meningitis: a randomized clinical trial |
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| Authors: | Sepideh Elyasi Hossein Khalili Simin Dashti-Khavidaki Hamid Emadi-Koochak |
| Institution: | 1. Mashhad University of Medical Sciences, Department of Clinical Pharmacy, Faculty of Pharmacy, Mashhad, Iran;2. Tehran University of Medical Sciences, Department of Clinical Pharmacy, Faculty of Pharmacy, Enghelab Ave, P.O.Box:14155/6451, Tehran 1417614411, Iran +98 912 2979329;3. +98 21 66461178;4. khalilih@tums.ac.ir;5. Tehran University of Medical Sciences, Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran, Iran;6. Tehran University of Medical Sciences, Department of Infectious Diseases, Faculty of Medicine, Tehran, Iran |
| 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. Conclusion: 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. |
| Keywords: | bacterial meningitis clinical response nephrotoxicity vancomycin |