I know of a patiemt who has seizures many times a day when not on vancomycin, but it seems he has to be on the drug daily to avoid grand mal seizures. Are there other effects of vancomycin on the biochemistry that may explain why this happens? I have found evidence of direct biochemical effects of many other antibiotics, but I have had not much luck finding info on vancomycin. I would especially love to find someone who looks at this issue more broadly with other antibiotics. Thanks!
Hi Susan,
Apparently, the penetration of vancomycin into the central nervous system is normally quite poor, according to this abstract:
http://www.ncbi.nlm.nih.gov/pubmed/23529866
and this remark in the drug insert: "Vancomycin does not readily diffuse across normal meninges into the spinal fluid; but, when the meninges are inflamed, penetration into the spinal fluid occurs."
Perhaps the patient has a compromised blood-brain barrier as a result of epilepsy or meningitis, allowing greater than normal penetration of the drug. If the seizures are caused by a Gram positive infection of the CNS, then vancomycin may prevent them by keeping the bacterial burden under control.
Another idea is that the seizures were caused by a different antibiotic (some are known to have this side effect: http://www.ncbi.nlm.nih.gov/pubmed/8487076), but when the patient was switched from that antibiotic onto vancomycin, the seizures stopped.
Dear Susan.
It's highly unlikely vancomycin is having a direct anti epileptic activities as such. I am in line with the probable action of vancomycin due to the given condition of your patient as explained by Adam .Its important to note that we cannot extrapolation based on your patient and further research needs to be carried out.
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