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Intraventricular Drug Delivery and Sampling for Pharmacokinetics and Pharmacodynamics Study
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Intraventricular Drug Delivery and Sampling for Pharmacokinetics and Pharmacodynamics Study

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Variations in ventricular distribution of polymyxin B following intraventricular administration in patients with

Huifang Jiang1, Yangmin Hu1, Jing Cai2

  • 1Department of Pharmacy, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Antimicrobial Agents and Chemotherapy
|November 6, 2025
PubMed

Insights

Intraventricular Polymyxin B (PMB) successfully treated resistant Gram-negative brain infections. Unilateral administration achieved bilateral distribution, suggesting optimized dosing strategies for central nervous system infections.

Area of Science:

  • Infectious Diseases
  • Neuroscience
  • Pharmacology

Background:

  • Polymyxin B (PMB) is active against multidrug-resistant Gram-negative bacteria.
  • Intraventricular administration is used for central nervous system (CNS) infections when systemic therapy fails to achieve adequate cerebrospinal fluid (CSF) levels.

Purpose of the Study:

  • To describe successful treatment of carbapenem-resistant Gram-negative meningoencephalitis using intraventricular PMB.
  • To investigate the distribution and concentration of intraventricular PMB in CNS infections.

Main Methods:

  • Case series describing two patients with meningoencephalitis.
  • Intraventricular administration of Polymyxin B.
  • CSF sampling and concentration analysis.

Main Results:

  • Successful clinical outcomes in both patients treated with intraventricular PMB.
  • Unilateral PMB administration resulted in bilateral ventricular distribution.
  • Higher PMB concentrations were observed on the side of administration.
  • Reduced CSF drainage was associated with increased PMB concentrations.

Conclusions:

  • Intraventricular PMB is a viable treatment for resistant Gram-negative meningoencephalitis.
  • Unilateral administration may achieve adequate bilateral distribution.
  • CSF drainage influences PMB concentration, informing dosing strategies for CNS infections.
Keywords:
carbapenem-resistant gram-negative bacteriacentral nervous system infectiongram-negative bacteriaintraventricularpolymyxin B

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