“…Another concern with the rifampin-vancomycin combination is that each drug penetrates tissue differently based on kinetics. For example, vancomycin penetration into lung tissue is not sustained, and the same was seen for the meninges and infected bone, whereas rifampin easily penetrates these tissues (61,109,120). The rifampin-vancomycin in vitro interaction appears to range from antagonistic to indifferent, with very few synergistic studies (25,26,112,119,158,218,246,251,258,261).…”