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[Intraventricular antibiotic therapy]
A F Thilmann1, E Möbius, K Podoll
1Neurologische Klinik mit Klinischer Neurophysiologie, Alfried Krupp von Bohlen und Halbach Krankenhauses Essen.
Abstract:
While shunt infections are regularly treated with intraventricular antibiotics, the validity of such an application in bacterial meningitis of other origin is controversial. We report two cases of partly successful treatment with intraventricular Ceftazidime (10-20 mg twice per week). One patient with pseudomonas aeruginosa meningitis who was treated as an out-patient for nearly two years died after an attempted withdrawal of the intraventricular treatment. In our experience, intraventricular application of antibiotics can be a part of the therapeutic regimen in all cases of chronic meningitis with problematic bacteria. Depending on the bacillus, Ceftazidime, Vancomycin or Netilmicin can be recommended for intrathecal application.
Insights
Intraventricular antibiotics show promise for chronic meningitis caused by difficult bacteria. While not a cure-all, this treatment approach, including Ceftazidime, offers a potential therapeutic option for challenging cases.
Area of Science:
- Neuroscience
- Infectious Diseases
- Pharmacology
Background:
- Intraventricular antibiotic administration is standard for shunt infections.
- Its efficacy in bacterial meningitis of other origins remains debated.
Observation:
- Two cases of chronic meningitis treated with intraventricular Ceftazidime (10-20 mg twice weekly) are presented.
- One patient with Pseudomonas aeruginosa meningitis experienced prolonged outpatient treatment but ultimately succumbed after treatment withdrawal.
Findings:
- Intraventricular Ceftazidime demonstrated partial success in managing chronic meningitis.
- The study suggests intraventricular antibiotics can be a valuable component of treatment for chronic meningitis with problematic bacteria.
Implications:
- Intrathecal Ceftazidime, Vancomycin, or Netilmicin may be beneficial for specific bacterial meningitis cases.
- This approach warrants consideration in refractory or chronic meningitis scenarios.
- Further research is needed to establish optimal protocols and long-term outcomes.