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Evidence from a recent randomized controlled trial suggests that dexamethasone as adjunct therapy in adult pneumococcal meningitis reduces mortality and neurological sequelae. However, adding dexamethasone has the potential to reduce penetration of vancomycin into the cerebrospinal fluid (CSF). We sought to determine concentrations of vancomycin in serum and CSF of patients with suspected or proven pneumococcal meningitis receiving dexamethasone to assess the penetration of vancomycin into the CSF during steroid therapy.

clinical infectious diseases/clinical infectious diseases (online. university of chicago. press)

Levels of Vancomycin in Cerebrospinal Fluid of Adult Patients Receiving Adjunctive Corticosteroids to Treat Pneumococcal Meningitis: A Prospective Multicenter Observational Study