Table 3.
Common Intraventricular/Intrathecal Treatment Options
| Drug | Recommended Adult Daily Dose#2 | Loading Dose Suggested | Adverse Events Reported136 | Targeted Pathogens2,136 |
|---|---|---|---|---|
| Amikacin | 5–50mg | – | Transient hearing loss, seizures, chemical meningitis, radiculopathy (IT) | DTR Gram-negatives |
| Colistin | 10mg | 40mg | Chemical meningitis, seizures | DTR Gram-negatives |
| Daptomycin | 5mg | – | Limited data available | Gram-positives non-responding to systemic treatment |
| Gentamycin | 4–8mg | – | Equivalent to amikacin | DTR Gram-negatives |
| Polymyxin B | 5mg | – | Equivalent to colistin | DTR Gram-negatives |
| Tigecycline*176 | 4–8mg | – | None attributed to the drug | DTR Gram-negatives, especially if colistin-resistant as well; potentially VRE177 |
| Tobramycin | 5–20mg | – | Equivalent to amikacin | DTR Gram-negatives |
| Vancomycin | 5–20mg | – | CSF pleocytosis, headache | Gram-positives non-responding to systemic treatment |
Notes: *Limited data available. #Apart from tigecycline, according to Infectious Disease Society of America recommendations.2
Abbreviations: CSF, cerebrospinal fluid; DTR, difficult-to-treat resistant; IT, intrathecal; VRE, vancomycin-resistant enterococci.