Intraventricular chemotherapy in neonatal meningitis
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Neonatal meningitis in infants often involves ventriculitis. Intraventricular antibiotic chemotherapy, combined with systemic treatment, significantly reduced mortality rates in this study.
Area of Science:
- Neonatalogy
- Infectious Diseases
- Pediatric Neurology
Background:
- Neonatal meningitis is a serious infection in newborns.
- Ventriculitis frequently accompanies neonatal meningitis, posing treatment challenges.
- Gram-negative organisms are common causative agents.
Purpose of the Study:
- To evaluate the efficacy of intraventricular antibiotic chemotherapy as an adjunct to systemic treatment for neonatal meningitis with ventriculitis.
- To assess the impact of this combined treatment approach on mortality and neurological outcomes.
Main Methods:
- A cohort of 16 infants with neonatal meningitis was treated over 30 months.
- All infants received systemic and intraventricular antibiotics.
- Antibiotic concentrations in cerebrospinal fluid were monitored during treatment.
Main Results:
- 15 out of 16 infants had concurrent ventriculitis, predominantly gram-negative.
- 15 infants survived the infection.
- Seven of the survivors had normal neurological outcomes at follow-up.
Conclusions:
- Intraventricular antibiotic chemotherapy is a valuable adjunct to systemic therapy for neonatal meningitis and ventriculitis.
- This combined approach significantly decreases mortality rates in affected infants.
- Further research into optimizing intraventricular antibiotic delivery and monitoring is warranted.
Abstract:
All of 16 infants with neonatal meningitis treated during a 30-month period were found to have accompanying ventriculitis at the time of the initial ventricular puncture. Fifteen of these infants were caused by gramm-negative organisms. All infants received antibiotics systemically and intraventricularly via an implanted ventriculostomy reservoir or by direct ventricular injection. Antibiotic concentrations within the ventricular fluid were monitored during chemotherapy; the complications encountered during treatment are discussed. Fifteen infants survived the infection; of these, seven infants were normal at follow-up examinations. In our experience intraventricular chemotherapy as an adjunct to systemic administration of antibiotics has greatly reduced the mortality rate in neonatal meningitis.