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Intraventricular antibiotics for bacterial meningitis in neonates
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| bet | 617/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Intraventricular antibiotics for bacterial meningitis in neonates: In a single trial that enrolled infants with Gram‐negative meningitis and ventriculitis, the use of intraventricular gentamicin in addition to intravenous antibiotics resulted in a three‐fold increased RR for mortality compared to standard treatment with intravenous antibiotics alone. No trial used intraventricular vancomycin. Based on this result, intraventricular antibiotics as tested in this trial should be avoided.[10] Arnell et al 2007 [11] reported 10 children (0 to 15 years) with intraventricular shunt infections initially treated with IV antibiotics for at least 3 days, but this treatment did not sterilise the CSF. After externalisation of the ventricular catheter, high-dose intraventricular treatment with daily instillations of vancomycin or gentamicin with trough concentrations held at high levels of 7 to 17 mg/L for both antibiotic agents resulted in quick sterilisation of the CSF, a low relapse rate and survival of all patients. The intraventricular vancomycin dose varied between 1 and 10 mg per day. [LOE IV]
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