Gump D W
Rev Infect Dis. 1981 Nov-Dec;3 suppl:S289-92.
Clinical experience with vancomycin for the treatment of bacterial meningitis has not been extensive. Presently available data indicate that when meningeal inflammation is present intravenously administered vancomycin penetrates into cerebrospinal fluid and therapeutically effective levels of drug therein are frequently attained. Treatment of meningitis with vancomycin has been effective in clinical situations that precluded the use of the commonly administered agents, i.e., in infections due to resistant strains or to unusual organisms, in patients allergic to penicillin, and in patients for whom therapy with a first-choice antibiotic has failed. When response to intravenously administered vancomycin was unsatisfactory, the addition of intrathecal therapy resulted in a favorable outcome in some patients. Combination therapy with agents that act synergistically with vancomycin has been beneficial. Vancomycin warrants serious consideration as a useful alternate antibiotic for the treatment of bacterial meningitis.
万古霉素用于治疗细菌性脑膜炎的临床经验并不丰富。现有数据表明，当存在脑膜炎症时，静脉注射万古霉素可穿透进入脑脊液，且其中常能达到治疗有效的药物水平。在一些无法使用常用药物的临床情况下，使用万古霉素治疗脑膜炎已取得成效，即针对耐药菌株或不常见病原体引起的感染、对青霉素过敏的患者，以及一线抗生素治疗失败的患者。当静脉注射万古霉素的疗效不令人满意时，加用鞘内治疗在一些患者中取得了良好效果。与能与万古霉素协同作用的药物联合治疗已证明有益。万古霉素作为治疗细菌性脑膜炎的一种有用替代抗生素值得认真考虑。
