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Intraventricular administration is considered when systemic therapy yields suboptimal cerebrospinal fluid (CSF) levels. We describe two cases of carbapenem-resistant gram-negative meningoencephalitis successfully treated with intraventricular PMB, in which unilateral PMB administration appeared to achieve bilateral ventricular distribution, with higher concentrations on the administration side. A potential association was observed between reduced CSF drainage and increased PMB concentrations. These findings may offer preliminary insights into optimizing PMB dosing strategies for CNS infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00943-25","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T15:45:37Z","timestamp":1762443937000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":4,"title":["Variations in ventricular distribution of polymyxin B following intraventricular administration in patients with central nervous system infections"],"prefix":"10.1128","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1772-0659","authenticated-orcid":false,"given":"Huifang","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Pharmacy, The Second Affiliated Hospital, Zhejiang University School of Medicine","place":["Hangzhou, 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