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Cerebrospinal Fluid Concentrations of Quinupristin‐Dalfopristin in a Patient with Vancomycin‐Resistant Enterococcus faecalis Ventriculitis

A 44‐year‐old man was treated successfully for vancomycin‐resistant Enterococcus faecium (VREF) ventriculitis with intrathecal quinupristin‐dalfopristin 1 mg, 2 mg, and 4 mg, and other intravenous antibiotics. Cerebrospinal fluid samples were collected before and after the 1‐mg and 2‐mg doses to determine the concentrations of quinupristin‐dalfopristin and its active metabolites. Concentrations were above the minimum inhibitory concentration for VREF immediately after unclamping the extraventricular drain and were quantifiable for at least 7 hours.