Instillation of vancomycin into a cerebrospinal fluid reservoir to clear infection: pharmacokinetic considerations.
 Vancomycin instilled in an Ommaya reservoir was used to treat a reservoir-associated infection.
 Vancomycin concentrations in cerebrospinal fluid (CSF) were measured, and derivation of pharmacokinetic parameters allowed tailoring of dosing.
 First-order kinetics were observed.
 The calculated half-life of 3.52 h was less than reported by others, and the apparent volume of distribution (60 ml) was less than anticipated.
 The elimination constant was 0.197 h-1.
 Empiric dosing based on schedules suggested in the literature would have led to high peak and low mean concentrations of intrareservoir vancomycin.
 Patients with reservoir-associated infections have a variety of pathophysiologic conditions that can result in alteration of normal CSF dynamics.
 Pharmacokinetic analysis is useful to individualize dosing and to optimize therapy with intrareservoir vancomycin.
