Abstract
Abstract
Objective
To systematically review the evidence for intrathecal or intraventricular plus intravenous administration of antibiotics compared with standard management for postsurgical meningitis or ventriculitis.
Methods
The following databases were searched: MEDLINE, the Central Register of Controlled Trials (CENTRAL); PubMed, EMBASE; and reference list of articles.
Results
Administration of intrathecal/intraventricular antibiotics was associated with decreased mortality (OR 0.27 [95% CI 0.15–0.49] p = < 0.00001), increased cure rate (OR 3.4 [95% CI 1.6–7.22] p = 0.001). There was no difference in the occurrence of reinfection rate, and in poor functional outcome (OR 0.57 [95% CI 0.21–1.60] p = 1.6 p = 0.29; OR 0.43 [95% CI 0.11–1.68] p = 0.22).
Conclusions
Intrathecal/intraventricular plus intravenous administration of antibiotics improves survival and cure rate in patients with postoperative meningitis or ventriculitis. More high-quality studies are needed.
Publisher
Springer Science and Business Media LLC
Subject
General Materials Science
Reference22 articles.
1. Beer R, Lackner P, Pfausler B, Schmutzhard E. Nosocomial ventriculitis and meningitis in neurocritical care patients. J Neurol. 2008;255:1617–24.
2. Mombelli G, Klastersky J, Coppens L, Daneau D, Nubourgh Y. Gram-negative bacillary meningitis in neurosurgical patients. J Neurosurg. 1983;59:634–41.
3. Rodríguez-Lucas C, Fernández J, Martínez-Sela M, et al. Pseudomonas aeruginosa nosocomial meningitis in neurosurgical patients with intraventricular catheters: therapeutic approach and review of the literature. Infect Diseases Clin Microbiol. 2020;38:54–8.
4. Abad-Restrepo J, Díaz-Díaz A, Osorio-Cadavid N. Post-surgical ventriculitis due to extensively resistant Pseudomonas aeruginosa treated with intrathecal colistin. Communication of a pediatric case and review of the scientific literature. Chil J Infectol. 2018;35:321–5.
5. Iaria C, Giammalva GR, Spicola D, et al. Multidrug-resistant Gram-negative post-neurosurgical meningitis and the role of intraventricular colistin: a case series. Le Infect Med. 2021;29:130–7.