Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1987 Nov;50(11):1419–1423. doi: 10.1136/jnnp.50.11.1419

Intraventricular vancomycin in the treatment of ventriculitis associated with cerebrospinal fluid shunting and drainage.

R Bayston 1, C A Hart 1, M Barnicoat 1
PMCID: PMC1032551  PMID: 3694201

Abstract

The results of treatment of 50 cases of ventriculitis associated with the use of cerebrospinal fluid shunts or external ventricular drains, and treated with intraventricular vancomycin, are reported. While the overall cure rate was 66% with four cases lost to follow-up, in those cases where treatment involved shunt removal, 20 mg vancomycin daily intraventricularly, and another appropriate systemic antibiotic, 22 of 24 cases were cured with two cases lost to follow-up. In those cases where the shunt was left in during treatment, results were poor and revision for blockage of the distal catheter of ventriculoperitoneal shunts was required in 44% of these. All five patients whose ventriculitis followed external ventricular drainage were cured. Despite relatively high trough levels of vancomycin in the cerebrospinal fluid, no evidence of toxicity was seen.

Full text

PDF
1422

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barriere S. L., Lutwick L. I., Jacobs R. A., Conte J. E. Vancomycin treatment for enterococcal meningitis. Arch Neurol. 1985 Jul;42(7):686–688. doi: 10.1001/archneur.1985.04060070076020. [DOI] [PubMed] [Google Scholar]
  2. Bayston R., Barnicoat M., Cudmore R. E., Guiney E. J., Gurusinghe N., Norman P. M. The use of intraventricular vancomycin in the treatment of CSF shunt-associated ventriculitis. Z Kinderchir. 1984 Dec;39 (Suppl 2):111–113. doi: 10.1055/s-2008-1044299. [DOI] [PubMed] [Google Scholar]
  3. Bayston R. Hydrocephalus shunt infections and their treatment. J Antimicrob Chemother. 1985 Mar;15(3):259–261. doi: 10.1093/jac/15.3.259. [DOI] [PubMed] [Google Scholar]
  4. Gombert M. E., Landesman S. H., Corrado M. L., Stein S. C., Melvin E. T., Cummings M. Vancomycin and rifampin therapy for Staphylococcus epidermidis meningitis associated with CSF shunts: report of three cases. J Neurosurg. 1981 Oct;55(4):633–636. doi: 10.3171/jns.1981.55.4.0633. [DOI] [PubMed] [Google Scholar]
  5. James H. E., Walsh J. W., Wilson H. D., Connor J. D., Bean J. R., Tibbs P. A. Prospective randomized study of therapy in cerebrospinal fluid shunt infection. Neurosurgery. 1980 Nov;7(5):459–463. doi: 10.1227/00006123-198011000-00006. [DOI] [PubMed] [Google Scholar]
  6. Krontz D. P., Strausbaugh L. J. Effect of meningitis and probenecid on the penetration of vancomycin into cerebrospinal fluid in rabbits. Antimicrob Agents Chemother. 1980 Dec;18(6):882–886. doi: 10.1128/aac.18.6.882. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Pau A. K., Smego R. A., Jr, Fisher M. A. Intraventricular vancomycin: observations of tolerance and pharmacokinetics in two infants with ventricular shunt infections. Pediatr Infect Dis. 1986 Jan-Feb;5(1):93–96. [PubMed] [Google Scholar]
  8. Raoult D., Kohler J. L., Gallais H., Casanova P. Septicémie è Staphylocoque épidermidis multirésistant avec localisation méningée. Guérison par administration générale et intra-thécale de vancomycine. Nouv Presse Med. 1981 Dec 26;10(47):3855–3856. [PubMed] [Google Scholar]
  9. Ring J. C., Cates K. L., Belani K. K., Gaston T. L., Sveum R. J., Marker S. C. Rifampin for CSF shunt infections caused by coagulase-negative staphylococci. J Pediatr. 1979 Aug;95(2):317–319. doi: 10.1016/s0022-3476(79)80682-4. [DOI] [PubMed] [Google Scholar]
  10. Ryan J. L., Pachner A., Andriole V. T., Root R. K. Enterococcal meningitis: combined vancomycin and rifampin therapy. Am J Med. 1980 Mar;68(3):449–451. doi: 10.1016/0002-9343(80)90118-7. [DOI] [PubMed] [Google Scholar]
  11. Schaad U. B., McCracken G. H., Jr, Nelson J. D. Clinical pharmacology and efficacy of vancomycin in pediatric patients. J Pediatr. 1980 Jan;96(1):119–126. doi: 10.1016/s0022-3476(80)80347-7. [DOI] [PubMed] [Google Scholar]
  12. Visconti E. B., Peter G. Vancomycin treatment of cerebrospinal fluid shunt infections. Report of two cases. J Neurosurg. 1979 Aug;51(2):245–246. doi: 10.3171/jns.1979.51.2.0245. [DOI] [PubMed] [Google Scholar]
  13. Wald S. L., McLaurin R. L. Cerebrospinal fluid antibiotic levels during treatment of shunt infections. J Neurosurg. 1980 Jan;52(1):41–46. doi: 10.3171/jns.1980.52.1.0041. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES