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[The efficacy of intraventricularly administered vancomycin in the case of central nervous system infection caused by

Sławomir L Czaban1, Wojciech J Lebkowski, Jacek P Krajewski

  • 1Kliniki Anestezjologii i Intensywnej Terapii, Akademii Medycznej w Białymstoku.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|February 28, 2003
PubMed

Insights

Intraventricular Vancomycin effectively treated cerebro-meningitis caused by Enterococcus faecalis when intravenous therapy failed. This approach bypasses the blood-brain barrier for direct antibiotic delivery to the cerebrospinal fluid (CSF).

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Pharmacology

Background:

  • Subarachnoid hemorrhage with intraventricular bleeding can lead to cerebro-meningitis.
  • Enterococcus faecalis, a pathogen resistant to standard intravenous glycopeptide antibiotics, can cause severe infections.
  • The blood-brain barrier often limits antibiotic penetration into the cerebrospinal fluid (CSF).

Observation:

  • A 40-year-old male patient presented with subarachnoid hemorrhage, intraventricular bleeding, and cerebro-meningitis due to Enterococcus faecalis.
  • Standard intravenous Vancomycin and Teicoplanin were ineffective, and the patient's condition worsened with sepsis.
  • Intraventricular Vancomycin (20 mg/day) was administered due to the ineffectiveness of intravenous therapy.

Findings:

  • The patient showed gradual recovery within two days of intraventricular Vancomycin administration.
  • Meningitis symptoms resolved, and cerebrospinal fluid (CSF) parameters normalized.
  • No bacterial growth was detected in blood serum or CSF, indicating successful eradication of Enterococcus faecalis.

Implications:

  • Intraventricular Vancomycin is an effective treatment for cerebro-meningitis, particularly when caused by resistant bacteria.
  • Direct intraventricular antibiotic administration can overcome blood-brain barrier limitations for treating central nervous system infections.
  • This therapeutic strategy offers an alternative for managing cerebro-meningitis when intravenous antibiotic efficacy is compromised or dose reduction is necessary.

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