Background: Central nervous system (CNS) infections are particularly prevalent in the adult neurocritical care patient population and are associated with significant morbidity and mortality. Factors relevant to the nature of CNS infections pose significant challenges to clinicians treating afflicted patients. Intraventricular (IVT) administration of antibiotics may offer several benefits over systemic therapy; however, the outcomes and current practices of such treatments are poorly described in the literature.
Objective: To describe current practices and outcomes of patients receiving intraventricular antibiotic treatment for CNS infections in neurological intensive care units of academic medical centers nationwide.
Methods: A retrospective cohort study was conducted on patients admitted to intensive care units who received IVT antibiotic treatment at participating centers in the USA between January 01, 2003, and December 31, 2013. Clinical and laboratory parameters, microbiology, surgical and antimicrobial management, and treatment outcomes were collected and described.
Results: Of the 105 patients included, all received systemic antimicrobial therapy along with at least one dose of IVT antimicrobial agents. Intraventricular vancomycin was used in 52.4% of patients. The average dose was 12.2 mg/day for a median duration of 5 days. Intraventricular aminoglycosides were used in 47.5% of the patients, either alone or in combination with IVT vancomycin. The average dose of gentamicin/tobramycin was 6.7 mg/day with a median duration of 6 days. Overall mortality was 18.1%. Cerebrospinal fluid (CSF) culture sterilization occurred in 88.4% of the patients with a rate of recurrence or persistence of positive cultures of 9.5%.
Conclusion: Intraventricular antimicrobial agents resulted in a high CSF sterilization rate. Contemporary use of this route typically results in a treatment duration of less than a week. Prospective studies are needed to establish the optimal patient population, as well as the efficacy and safety of this route of administration.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s12028-018-0647-0 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Rare-earth oxide promoted Pd electrocatalyst for formic acid oxidation.
Dalton Trans
January 2025
Fujian Provincial Key Laboratory of Advanced Materials Oriented Chemical Engineering, College of Chemistry & Materials Science, Fujian Normal University, Fuzhou, Fujian 350007, P. R. China.
The development of Pd-based materials with high activity and long-term stability is crucial for their practical applications as an anode catalyst in direct formic acid fuel cells. Herein, we reveal that the catalytic activity of Pd towards formic acid oxidation can be enhanced by incorporation of a series of rare-earth oxides, including ScO, CeO, LaO, and PrO. For example, Pd nanoparticles incorporated with ScO supported on nitrogen-doped reduced graphene oxide (Pd-ScO/N-rGO-, = 1/3, 1/2, 2/3, 1, and 3/2; "" denotes the molar ratio of Pd : Sc) can be obtained using a sodium borohydride reduction method.
View Article and Find Full Text PDFEvidence synthesis of health policy and systems research in rehabilitation: a protocol for Cochrane overviews of systematic reviews on delivery, governance, financial arrangements, and implementation strategies.
Eur J Phys Rehabil Med
January 2025
Rehabilitation Program, Department for Noncommunicable Diseases, Rehabilitation and Disability, World Health Organization, Geneva, Switzerland.
Cochrane Rehabilitation and the World Health Organization (WHO) Rehabilitation Program are collaborating to produce four Cochrane overviews of systematic reviews that synthesize the current evidence from health policy and systems research (HPSR) in rehabilitation. They will focus on the four pillars of HPSR identified by the Cochrane Effective Practice and Organization of Care (EPOC) taxonomy: delivery arrangements, financial arrangements, governance arrangements, and implementation strategies. The protocol describes why HPSR is currently needed in rehabilitation, provides detailed information on the four EPOC pillars in interaction with rehabilitation and reports the Cochrane methods that will be followed to produce the overviews.
View Article and Find Full Text PDFConsiderations for Perioperative Management Guidance Regarding GLP-1 Receptor Agonists: Evaluation of Current Practices and Future Directions.
Mil Med
January 2025
Department of Anesthesiology, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.
Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become increasingly prevalent and have the potential to delay gastric emptying. The American Society of Anesthesiologists (ASA) released guidance regarding the perioperative management of patients receiving GLP-1 RAs, but it is unclear the extent to which hospitals in the U.S.
View Article and Find Full Text PDFCore-Satellite Gold Nanoparticle@Silver Nanocluster Nanohybrids for Milk Allergen β-Lactoglobulin Detection Using the Electrochemical Aptasensor.
J Agric Food Chem
January 2025
College of Chemistry and Chemical Engineering, Jishou University, Jishou, Hunan 416000, P. R. China.
Detecting β-lactoglobulin (β-Lg) with high sensitivity and selectivity is an urgent requirement due to nearly 80% of milk anaphylaxis, such as respiratory tract, skin urticaria, and gastrointestinal disorders, being caused by β-Lg. An ultrasensitive β-Lg electrochemical aptasensor utilizing core-satellite gold nanoparticle@silver nanocluster (AuNPs@AgNCs) nanohybrids as electrocatalysts was developed. First, β-Lg aptamer was anchored on gold electrodes and AuNPs to obtain high selectivity.
View Article and Find Full Text PDFA leaf-like structured membrane for highly efficient and persistent radiative cooling.
Mater Horiz
January 2025
Key Laboratory of Polymer Processing Engineering of the Ministry of Education, National Engineering Research Center of Novel Equipment for Polymer Processing, Guangdong Provincial Key Laboratory of Technique and Equipment for Macromolecular Advanced Manufacturing, South China University of Technology, Guangzhou 510641, People's Republic of China.
Passive daytime radiative cooling offers a promising approach to address energy, environmental, and safety issues caused by global warming. However, the contradiction between high radiative cooling performance and long-lasting ultraviolet (UV) durability is a primary limitation at the current stage. Here, inspired by the ability of epidermal cells and palisade cells on the leaf surface to protect internal leaf structures (such as chloroplasts and nuclei) under drought and high-temperature conditions, a double-layer passive radiative cooling (PRC) porous membrane, which consists of an upper protective layer densely packed with highly ultraviolet-reflective inorganic particles and a bottom cooling layer doped with a variety of optically characterized inorganic particles, was developed to overcome these challenges.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!