#Cid episode 1310 plus#

#Cid episode 1310 plus#

Since 1996, written institutional guidelines at our hospital have recommended cefotaxime plus vancomycin for the empirical treatment of neurosurgical meningitis or ventriculitis.

In these studies, aminoglycosides have been administered intravenously, intraventricularly, intralumbarly, or in combinations of these administration routes. In previous clinical reports, combination therapy with aminoglycosides has been used in treating all or some of the patients. Following increased rates of resistance to these antibiotics in gram-negative bacteria, carbapenems have been suggested as empirical treatment. Since the early 1980s, third-generation cephalosporins have been used for the treatment of GNB meningitis. In recent studies, mortality attributable to meningitis has been reported to be 3%вЂ“12%. The overall mortality rate among patients with neurosurgical gram-negative bacillary (GNB) ventriculitis or meningitis has been reported to be 8%вЂ“70%, with the highest rates being reported before the introduction of third-generation cephalosporins. Gram-negative etiology is associated with severe underlying disease and a worse prognosis. Postneurosurgical ventriculomeningitis is typically caused by Staphylococcus aureus or coagulase-negative staphylococci. In addition, the underlying trauma or neurosurgery may result in a meningeal inflammatory response that will consequently affect cerebrospinal fluid (CSF) parameters. Clinically, the diagnosis is often difficult to establish because of its sometimes insidious onset and atypical symptoms. Meropenem seems to be an effective and safe alternative for the systemic antibiotic treatment of these neurointensive care infections.Д«acterial ventriculitis or meningitis is a relatively rare but serious complication after neurosurgery. The mortality rate was 19% 3 patients in each group died, but in no case was death considered to be attributable to meningitis.Д¬onclusions.вЂѓOur results support combination treatment with intraventricular gentamicin for postneurosurgical GNB ventriculomeningitis. Relapse occurred in 0 of 13 patients treated intraventricularly and in 6 of 18 patients treated with systemic antibiotics alone.

These patients had a higher cure rate and a lower relapse rate than did those treated with intravenous antibiotics alone ( P =. Thirteen patients were given combination treatment with appropriate intraventricular gentamicin. The main intravenous therapies were meropenem ( n = 24), cefotaxime ( n = 3), ceftazidime ( n = 2), imipenem ( n = 1), and trimethoprim-sulfamethoxazole ( n = 1). Results.вЂѓThirty-one patients with neurosurgical GNB ventriculitis or meningitis and follow-up for 3 months were identified. Data were abstracted from the medical records. Methods.вЂѓAdult consecutive patients with gram-negative bacteria isolated from cerebrospinal fluid during a 10-year period and with postneurosurgical GNB ventriculitis or meningitis were included retrospectively. In addition, we report our experience of meropenem for the treatment of GNB ventriculomeningitis. In this study, we retrospectively compare the efficacy of combination treatment with intraventricular gentamicin to that of systemic antibiotics alone.

At our hospital in Uppsala, Sweden, meropenem has been recommended as empirical therapy since 1996, with the addition of intraventricular gentamicin in cases that do not respond satisfactorily to treatment. Prospective studies on antibiotic treatment for these infections are lacking, and retrospective reports are sparse. Background.вЂѓGram-negative bacillary (GNB) ventriculitis and meningitis are rare but serious complications after neurosurgery.