Related Experiment Video
Updated: Feb 21, 2026
Intraventricular Drug Delivery and Sampling for Pharmacokinetics and Pharmacodynamics Study
Published on: March 31, 2022
Intrathecal and intraventricular antibiotics for postoperative Gram-negative meningitis and ventriculitis
Saad Akhtar Khan1, Muhammad Waqas2, Usman T Siddiqui2
1Section of Neurosurgery, The Memon Medical Institute, Karachi, Pakistan.
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.
Insights
Intraventricular/intrathecal (IVT/IT) antibiotics effectively treat postoperative gram-negative meningitis when intravenous options fail. This approach achieved cerebrospinal fluid sterility in all patients, offering a safe alternative for difficult infections.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Pharmacology
Background:
- Postoperative meningitis poses a significant challenge, particularly with the rise of multidrug-resistant organisms.
- Intravenous (IV) antibiotic efficacy is limited in certain complex meningitis cases.
Purpose of the Study:
- To evaluate the effectiveness of intraventricular/intrathecal (IVT/IT) antibiotic administration for postoperative gram-negative meningitis.
- To assess IVT/IT antibiotics in patients unresponsive to standard IV therapy.
Main Methods:
- Retrospective review of neurosurgery patients diagnosed with gram-negative postoperative meningitis/ventriculitis.
- Analysis of patient demographics, hospital course, and treatment outcomes.
Main Results:
- Twenty-one patients received IVT or IT antibiotics, with *Acinetobacter species* being the most common pathogen.
- Cerebrospinal fluid sterility was achieved in all patients, with no reported relapses.
- Treatment involved amikacin, polymyxin B, or colistin, with one patient receiving combination therapy.
Conclusions:
- Intraventricular/intrathecal antibiotic therapy presents a viable and effective option for managing postoperative gram-negative meningitis.
- This treatment modality demonstrates minimal side effects in patients refractory to conventional intravenous antibiotics.
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