Meningitis

Offending Agent: Penicillin-resistant Strep. pneumonia (PRSP)

Drug of Choice: Vancomycin + ceftriaxone (or cefotaxime)

Physicochemical Properties of Vancomycin: - pKa: 7.75 (basic drug; partially ionized at physiological pH) - logP: -3.1 (highly hydrophilic; very limited lipid solubility)

Tissue Distribution Rationale: Vancomycin’s very low logP (-3.1) and large molecular size result in poor CNS penetration under normal conditions. However, during meningeal inflammation, increased blood-brain barrier permeability allows therapeutic CSF concentrations. The combination with ceftriaxone (better CNS penetration) provides broader coverage and improved CNS drug delivery.

PK/PD Target: AUC/MIC ≥ 400 (vancomycin) + %T>MIC ≥ 50% (ceftriaxone)

Key PK Parameters for Meningitis: - Volume of Distribution: 0.1-0.15 L/kg (poor CNS penetration for vancomycin) - CSF Penetration: Vancomycin CSF/plasma ratio ≈ 0.05-0.2 (inflamed meninges) - Protein Binding: Vancomycin ~90%, Ceftriaxone ~95% - CNS Dosing: Higher doses needed due to blood-brain barrier

This interactive module demonstrates multiple dosing pharmacokinetics using patient-specific parameters.

Patient Generator

  • Age: - years
  • Sex: -
  • Height: - cm
  • Weight: - kg
  • Creatinine: - mg/dL

Fast (IV Bolus)

PK Parameters

1.0

0.9

0.65 L/kg

0.85

Dosing

1250 mg

1000 mg

12 hrs

10 days

Loading interactive chart…

20 mg/L

5 mg/L

Subject Drug Name Age Sex Ht (cm) Wt (kg) BMI IBW (kg) Adj IBW (kg) Creatinine (mg/dL) CrCl (mL/min) Loading Dose (mg) Dose (mg) Interval (hrs) Duration (days) Clearance (L/h) Volume (L) Fraction Unbound Vss,u (L) Bioavailability Half-life (h) Css,avg AUC0-24h Cmax AUC/Efficacy Cmax/Efficacy Time>Efficacy (%)

Meningitis-Specific Pharmacokinetic Concepts

Blood-Brain Barrier Challenges: The CNS is a pharmacokinetic sanctuary site due to tight junctions in brain capillaries. Most antibiotics, including vancomycin, have poor CNS penetration with CSF/plasma ratios of only 0.05-0.2 even in inflamed meninges.

Combination Therapy Rationale: Vancomycin + ceftriaxone combination provides: - Vancomycin: covers MRSA and resistant enterococci (though poor CNS penetration) - Ceftriaxone: excellent CNS penetration (CSF/plasma ≈ 0.1-0.3) and covers resistant S. pneumoniae

Volume of Distribution for CNS Infections: The restrictive Vd (0.1-0.15 L/kg) for vancomycin means most drug remains in plasma, requiring higher doses to achieve therapeutic CSF concentrations.

AUC-Guided Dosing in Meningitis: Target AUC₀₋₂₄/MIC ≥ 400 requires aggressive dosing due to poor penetration. Some cases may need intrathecal administration for resistant organisms.

CSF Sampling Considerations: CSF drug concentrations are often monitored in severe cases. Timing of lumbar puncture relative to dosing affects interpretation of results.

Duration and Monitoring: CNS infections require prolonged therapy (14-21 days) with careful monitoring for neurotoxicity and nephrotoxicity from high-dose regimens.

Blood Sampling Strategy

In this simulation, blood samples are collected every 1 hour to provide a detailed view of how pharmacokinetic data is collected in clinical practice. This sampling frequency allows us to:

  • Capture both peak and trough concentrations
  • Observe the full absorption and elimination phases
  • Reduce the burden on patients compared to more frequent sampling
  • Provide sufficient data points for pharmacokinetic analysis

Simplified Pharmacokinetic Model

This simulation uses a simplified one-compartment model with first-order absorption that focuses on the minimum essential parameters needed to generate a multiple dosing pharmacokinetic plot:

Essential PK Parameters: - Clearance (CL): Automatically calculated from patient’s creatinine clearance using Cockcroft-Gault equation - Volume of Distribution (Vd): Drug-specific volume per kg multiplied by patient weight - Bioavailability (F): Fraction of dose reaching systemic circulation

Patient-Specific Factors: - Creatinine Clearance: Calculated using Cockcroft-Gault: CrCl = [(140 - age) × weight × (0.85 if female)] / (72 × serum creatinine) - Weight-Based Dosing: Volume of distribution scales directly with patient weight

Dosing Parameters: - Dose: Amount of drug administered per dose - Dosing Interval: Time between doses - Treatment Duration: Total length of treatment

This approach incorporates key patient-specific factors (age, sex, weight, creatinine) while maintaining the core functionality needed to understand multiple dosing pharmacokinetics and the clinical application of the Cockcroft-Gault equation.

Test your understanding by calculating the following parameters for the current patient:

1. Creatinine Clearance (mL/min):

2. Adjusted Body Weight (kg):

3. Volume of Distribution of Unbound Drug (L):

4. Time to Steady State - tss (hours):

5. Average Steady-State Concentration - Css,avg (mg/L):

6. Vancomycin PK/PD: Based on vancomycin’s pKa (7.75) and physiological pH (7.4), what percentage of the drug is ionized?

Hint: Use Henderson-Hasselbalch equation. For bases: ionized % = 100 × 1/(1 + 10^(pH-pKa))

7. CNS Penetration: Why does vancomycin achieve therapeutic CSF concentrations in meningitis despite poor blood-brain barrier penetration?

8. Combination Therapy: What is the primary pharmacokinetic rationale for combining vancomycin with ceftriaxone in meningitis?