{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T04:30:05Z","timestamp":1744173005819,"version":"3.40.3"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Postneurosurgical meningitis (PNM) is a serious medical condition with high mortality and morbidity caused by Gram positive organisms like Staphylococcus aureus and Gram-negative organisms like Acinetobacter baumannii. Optimum concentration of antibiotics in the cerebrospinal fluid (CSF) to treat these infections is difficult to achieve. Intraventricular antibiotic administration bypasses the blood\u2013brain barrier and can achieve high CSF concentration without causing systemic toxicity.<\/jats:p><jats:p>\n          Methods\u2003Retrospective review of all patient records were done to identify patients who developed postneurosurgical meningitis and received intraventricular antibiotic therapy during the period of July 2017 to December 2022. Demographic and clinical data along with the type of antibiotic, route, dose, and duration of administration were collected. CSF parameters before and after intraventricular antibiotic administration were collected and analyzed.<\/jats:p><jats:p>\n          Results\u2003Twenty-six patients with postneurosurgical meningitis received intraventricular antibiotic therapy. Intracranial tumors were the most common underlying pathology followed by aneurysms. In all, 17\/26 patients had received vancomycin and 9\/26 patients had received colistin. External ventricular drain was used in 17\/26 cases and Ommaya reservoir was used in 9\/26 cases. Six patients showed growth of organism in CSF before starting intraventricular antibiotics, while one patient remained culture positive despite treatment. Of the 26 patients, 3 died despite treatment. There were significant changes in the CSF parameters after intraventricular antibiotic therapy.<\/jats:p><jats:p>\n          Conclusion\u2003Intraventricular administration of antibiotic provides an alternative therapeutic option in the management of patients who are not responding or poorly responding to systemic antibiotics.<\/jats:p>","DOI":"10.1055\/a-2312-9276","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T23:02:36Z","timestamp":1713999756000},"page":"272-277","source":"Crossref","is-referenced-by-count":0,"title":["Clinical, Microbiological Profile, and Treatment Response to Intraventricular Antibiotics in the Management of Postneurosurgical Meningitis: A Single-Center Experience"],"prefix":"10.1055","volume":"86","author":[{"given":"Debajyoti","family":"Datta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences \u2013 Bhubaneswar, Bhubaneswar, Orissa, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9664-6620","authenticated-orcid":false,"given":"Arunkumar","family":"Sekar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sakra World Hospital, Bangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Pasha","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences \u2013 Bhubaneswar, Bhubaneswar, Orissa, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashis","family":"Patnaik","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences \u2013 Bhubaneswar, Bhubaneswar, Orissa, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabi Narayan","family":"Sahu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences \u2013 Bhubaneswar, Bhubaneswar, Orissa, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumit","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences \u2013 Bhubaneswar, Bhubaneswar, Orissa, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/S0195-6701(98)90021-4","article-title":"The prognostic factors of adult gram-negative bacillary meningitis","volume":"40","author":"C H Lu","year":"1998","journal-title":"J Hosp Infect"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.jocn.2004.09.017","article-title":"Post-neurosurgical nosocomial bacterial meningitis in adults: microbiology, clinical features, and outcomes","volume":"12","author":"K W Wang","year":"2005","journal-title":"J Clin Neurosci"},{"issue":"09","key":"ref3","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.cmi.2017.05.013","article-title":"Management of post-neurosurgical meningitis: narrative review","volume":"23","author":"K Hussein","year":"2017","journal-title":"Clin Microbiol Infect"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s00134-005-0015-3","article-title":"Levels of vancomycin in the cerebral interstitial fluid after severe head injury","volume":"32","author":"A Caricato","year":"2006","journal-title":"Intensive Care Med"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"e34","DOI":"10.1093\/cid\/ciw861","article-title":"Infectious Diseases Society of America's clinical practice guidelines for healthcare-associated ventriculitis and meningitis","volume":"64","author":"A R Tunkel","year":"2017","journal-title":"Clin Infect Dis"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.3171\/2013.6.JNS122126","article-title":"Intraventricular and lumbar intrathecal administration of antibiotics in postneurosurgical patients with meningitis and\/or ventriculitis in a serious clinical state","volume":"119","author":"F Reme\u0161","year":"2013","journal-title":"J Neurosurg"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.ajic.2008.03.002","article-title":"CDC\/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting","volume":"36","author":"T C Horan","year":"2008","journal-title":"Am J Infect Control"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"458","DOI":"10.4103\/0028-3886.284354","article-title":"External ventricular drain related complications: whether continuous CSF drainage via Ommaya reservoir is the answer?","volume":"68","author":"H Singh","year":"2020","journal-title":"Neurol India"},{"issue":"09","key":"ref9","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1056\/NEJM198403013100903","article-title":"Ventriculostomy-related infections. A prospective epidemiologic study","volume":"310","author":"C G Mayhall","year":"1984","journal-title":"N Engl J Med"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/2045-8118-8-4","article-title":"Fluids and barriers of the CNS establish immune privilege by confining immune surveillance to a two-walled castle moat surrounding the CNS castle","volume":"8","author":"B Engelhardt","year":"2011","journal-title":"Fluids Barriers CNS"},{"issue":"07","key":"ref11","doi-asserted-by":"crossref","first-page":"e101961","DOI":"10.1371\/journal.pone.0101961","article-title":"The incidence and risk factors of meningitis after major craniotomy in China: a retrospective cohort study","volume":"9","author":"C Chen","year":"2014","journal-title":"PLoS One"},{"issue":"31","key":"ref12","doi-asserted-by":"crossref","first-page":"e4329","DOI":"10.1097\/MD.0000000000004329","article-title":"Risk factors associated with postcraniotomy meningitis: a retrospective study","volume":"95","author":"C H Chen","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1227\/01.neu.0000243291.61566.21","article-title":"Risk factors for adult nosocomial meningitis after craniotomy role of antibiotic prophylaxis","volume":"59","author":"A M Korinek","year":"2006","journal-title":"Neurosurgery"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1227\/01.NEU.0000255425.31797.23","article-title":"Efficacy of prophylactic antibiotics against meningitis after craniotomy: a meta-analysis","volume":"60","author":"F G Barker II","year":"2007","journal-title":"Neurosurgery"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/BF01403193","article-title":"Intra-operative antibiotic prophylaxis in neurosurgery. A prospective, randomized, controlled study on cefotiam","volume":"113","author":"T Gaillard","year":"1991","journal-title":"Acta Neurochir (Wien)"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.wneu.2016.02.048","article-title":"The efficacy of antibacterial prophylaxis against the development of meningitis after craniotomy: a meta-analysis","volume":"90","author":"A F Alotaibi","year":"2016","journal-title":"World Neurosurg"},{"issue":"01","key":"ref17","first-page":"7","article-title":"The management of neurosurgical patients with postoperative bacterial or aseptic meningitis or external ventricular drain-associated ventriculitis","volume":"14","author":"E M Brown","year":"2001","journal-title":"Br J Neurosurg"},{"issue":"03","key":"ref18","first-page":"348","article-title":"Intrathecal and intraventricular administration of antibiotics in gram-negative nosocomial meningitis in a research hospital in Turkey","volume":"31","author":"M Ayhan","year":"2021","journal-title":"Turk Neurosurg"},{"key":"ref19","first-page":"9923015","article-title":"Evaluation of intraventricular\/intrathecal antimicrobial therapy in the treatment of nosocomial meningitis caused by multidrug-resistant gram-negative bacteria after central nervous system surgery","volume":"2021","author":"N D Sari","year":"2021","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"226","DOI":"10.4103\/sni.sni_81_17","article-title":"Intrathecal and intraventricular antibiotics for postoperative gram-negative meningitis and ventriculitis","volume":"8","author":"S A Khan","year":"2017","journal-title":"Surg Neurol Int"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.cmi.2015.09.023","article-title":"Intrathecal or intraventricular therapy for post-neurosurgical gram-negative meningitis: matched cohort study","volume":"22","author":"B Shofty","year":"2016","journal-title":"Clin Microbiol Infect"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"e637","DOI":"10.1016\/j.wneu.2018.08.138","article-title":"The role of intraventricular antibiotics in the treatment of nosocomial ventriculitis\/meningitis from gram-negative pathogens: a systematic review and meta-analysis","volume":"120","author":"M Karvouniaris","year":"2018","journal-title":"World Neurosurg"},{"issue":"05","key":"ref23","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.ijantimicag.2019.08.002","article-title":"Intrathecal or intraventricular antimicrobial therapy for post-neurosurgical intracranial infection due to multidrug-resistant and extensively drug-resistant gram-negative bacteria: a systematic review and meta-analysis","volume":"54","author":"Y Hu","year":"2019","journal-title":"Int J Antimicrob Agents"},{"issue":"04","key":"ref24","first-page":"471","article-title":"Infections in neurologic surgery. The intraventricular use of antibiotic","volume":"12","author":"D Y Wen","year":"1992","journal-title":"Neurosurg Clin N Am"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1586\/14787210.2014.896740","article-title":"Intraventricular or intrathecal colistin for the treatment of central nervous system infections caused by multidrug-resistant gram-negative bacteria","volume":"12","author":"R Imberti","year":"2014","journal-title":"Expert Rev Anti Infect Ther"},{"issue":"05","key":"ref26","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1093\/jac\/dkl347","article-title":"Cure of multiresistant Acinetobacter baumannii central nervous system infections with intraventricular or intrathecal colistin: case series and literature review","volume":"58","author":"J Ng","year":"2006","journal-title":"J Antimicrob Chemother"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.ijantimicag.2017.12.002","article-title":"Outcomes of adjunctive therapy with intrathecal or intraventricular administration of colistin for post-neurosurgical meningitis and ventriculitis due to carbapenem-resistant Acinetobacter baumannii","volume":"51","author":"S Chusri","year":"2018","journal-title":"Int J Antimicrob Agents"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ijantimicag.2006.08.024","article-title":"Intraventricular or intrathecal use of polymyxins in patients with gram-negative meningitis: a systematic review of the available evidence","volume":"29","author":"M E Falagas","year":"2007","journal-title":"Int J Antimicrob Agents"},{"issue":"01","key":"ref29","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/ene.12789","article-title":"Intraventricular versus intravenous colistin for the treatment of extensively drug resistant Acinetobacter baumannii meningitis","volume":"23","author":"P De Bonis","year":"2016","journal-title":"Eur J Neurol"}],"container-title":["Journal of Neurological Surgery Part A: Central European Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2312-9276.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T23:26:07Z","timestamp":1744154767000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2312-9276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,24]]},"references-count":29,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2025,4,8]]},"published-print":{"date-parts":[[2025,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2312-9276","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6315","2193-6323"],"issn-type":[{"type":"print","value":"2193-6315"},{"type":"electronic","value":"2193-6323"}],"subject":[],"published-other":{"date-parts":[[2024,4,24]]},"published":{"date-parts":[[2024,4,24]]}}}