Related Experiment Videos
[Intrathecal gentamicin in the treatment of meningitis--clinical case study (author's transl)]
Abstract:
The authors report 33 cases of meningitis treated with intrathecally administered gentamicin (GM) and examine it's effectiveness for meningitis side effects and optimum dose. Of 33 cases 15 cases (group I1 were treated with GM alone 7 cases (group IIa) with GM combined with SB--PC or CP. In 8 cases of the other 11 cases (group IIb) GM was changed for SB--PC or CP because of it's inefficiency and side effects (6 cases) and other reasons (2 cases). In the remaining three cases of group IIb SB--PC or CP was changed for GM due to their inefficiecy. Maximum intrathecal dose is shown below : 4 mg--7 cases, 8 mg--5 cases, 10 mg--15 cases, 20 mg--4cases, 40 mg--2 cases. In all cases GM was not administered systemically, but each of CP, CB--PC, SB--PC and TC was administereed systemically. In group I, only one case did not G--I tract bleeding but the others were cured. In group IIa all but one case was cured. In group IIb one case of cyptococcosis was dead. Total effective cases of intrathecal GM were 17 of 24 cases excluding group IIa (7 cases) and 3 cases of group IIb. There was no side effect in cases of which maximum dose was 4--20 mg, but in one of 40 mg administered cases in which GM was injected from cisternal puncture hearing, vestibular and visual function were disturbed permanently. Therefore GM should not be injected into the cistern. In our conclusion intrathecal GM is thought to be effective in the treatment of meningitis without systemic GM. Effective optimum dose in 4--8 mg/day day in adult and if ineffective after 7--10 days GM should be changed for other antibiotics.
Insights
Intrathecal gentamicin (GM) effectively treats meningitis when not given systemically. Optimal daily doses range from 4–8 mg, with a change advised if ineffective within 7–10 days.
Area of Science:
- Infectious Diseases
- Pharmacology
- Neurology
Context:
- Meningitis treatment often involves antibiotics.
- Intrathecal administration bypasses systemic delivery for direct central nervous system access.
- Gentamicin (GM) has been used intrathecally for meningitis, but its efficacy and safety require further evaluation.
Purpose:
- To evaluate the effectiveness and side effects of intrathecally administered gentamicin (GM) for meningitis.
- To determine the optimal dosage and administration guidelines for intrathecal GM in meningitis patients.
- To compare outcomes of GM monotherapy versus combination therapy.
Summary:
- This study analyzed 33 meningitis cases treated with intrathecal gentamicin (GM). 17 of 24 cases showed effectiveness, with optimal doses between 4-20 mg. Doses of 40 mg, particularly via cisternal puncture, led to permanent sensory and motor disturbances.
- Combination therapy with other antibiotics showed high cure rates, while GM monotherapy was also effective in a significant portion of cases.
- No systemic GM was administered; however, other antibiotics were given systemically. Intrathecal GM is considered effective for meningitis when not administered systemically, with 4-8 mg/day as the effective optimum dose in adults.
Impact:
- Intrathecal GM can be an effective meningitis treatment option, particularly when systemic administration is contraindicated or less effective.
- Establishing safe dosage ranges (4-20 mg) and administration routes (avoiding cisternal puncture) is crucial for patient safety.
- The findings support the use of intrathecal GM as a targeted therapy for meningitis, with clear guidelines for its application and monitoring.