{"id":"c9208ac8-3df1-447e-9551-c9a938d0296f","slug":"intrathecal-and-intraventricular-antibiotics-for-postoperative-gram-negative-meningitis-and-ventriculitis","title":"Intrathecal and intraventricular antibiotics for postoperative Gram-negative meningitis and ventriculitis","authors":["Saad Akhtar Khan","Muhammad Waqas","Usman T. Siddiqui","Muhammad Shahzad Shamim","Karim Rizwan Nathani","Rashid Jooma","Faisal Mehmood"],"abstract":"Background: Postoperative meningitis is a growing cause of concern, especially with the evolution of multidrug-resistant organism. The authors evaluate the use of intraventricular/intrathecal (IVT/IT) antibiotics for postoperative gram-negative meningitis in patients whom intravenous antibiotics were ineffective. Methods: Medical records were retrospectively reviewed and neurosurgery patients with gram-negative postoperative infection meningitis/ventriculitis were enrolled in the study. Their demographics, hospital course, and outcomes were recorded in a pro forma and analyzed using Statistical Package for the Social Sciences, version 19. Results: The review identified 21 patients with postneurosurgical gram-negative meningitis/ventriculitis who were treated with IVT or IT antibiotics. The most common organism was Acinetobacter species (n = 14; 66%). Amikacin was used in 7 patients, polymyxin B in 9 patients, and colistin in 5 patients. A combination of antibiotics was used in one patient. Cerebrospinal fluid sterility was achieved in all patients with no incidence of relapse. There was a single death, though that was not related to the infectious process as the patient had a massive pulmonary embolism. Conclusion: The findings of this study suggest that IVT and IT antibiotic therapy is a useful option in patients who are nonresponsive to standard intravenous therapy with little or no side effects.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/c9208ac8-3df1-447e-9551-c9a938d0296f/featured/hero-1782420938764.png","publishDate":"2017-09-26T00:00:00.000Z","doi":"10.4103/sni.sni_81_17","categories":["Infection","Original Article"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2017/10/8619/SNI-8-226.pdf"}