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http://dx.doi.org/10.1159/000103974DOI Listing

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Objective: The Hydrocephalus Clinical Research Network (HCRN) implemented a perioperative infection prevention bundle for all CSF shunt surgeries in 2007 that included the relatively unproven technique of intrathecal instillation of the broad-spectrum antibiotics vancomycin and gentamicin into the shunt. In the meantime, the field debated the use of antibiotic-impregnated catheter (AIC) shunt tubing using clindamycin and rifampin, an increasingly widespread, but expensive and controversial, technique. It is unknown whether there were changes in infecting organisms associated with the use of these techniques during CSF shunt surgery at the hospital level.

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Background: Managing health care acquired and device-associated intracranial infections in young children can be challenging given adverse antibiotic side effects and difficulties in achieving adequate central nervous system (CNS) antibiotic concentrations. Ceftaroline is a cephalosporin with a favorable safety profile and activity against methicillin-resistant Staphylococci and several Gram-negative organisms. Published data on the use of ceftaroline for CNS infections in children and adults are limited.

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Background: Tuberculous meningitis (TBM) is the most lethal form of TB. To study the disease, drug concentrations in samples obtained from the spinal CSF are usually used to reflect brain concentrations. Emerging data suggest that transport of substances across capillaries in the brain (ventricular CSF) and spinal cord may differ.

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Article Synopsis
  • Limited research on how rifampicin, a drug for tuberculosis, moves through the body and into the brain in children with tuberculous meningitis (TBM) inspired this analysis of its distribution in cerebrospinal fluid (CSF) and brain tissue.
  • The study involved 61 children, aiming to quantify rifampicin levels in plasma, lumbar CSF, ventricular CSF, and brain extracellular fluid using advanced techniques like liquid chromatography and microdialysis.
  • Findings revealed that rifampicin concentrations are significantly lower in CSF than in plasma, confirming that the drug penetrates brain tissue and suggesting microdialysis as a useful method for studying drug distribution in TBM.
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Hydrocephalus is a neurological disease caused by an unusually high level of cerebrospinal fluid (CSF), which can be relieved by external ventricular drainage (EVD) insertion. However, the infection can lead to complications during the use of EVD. In this study, EVD was impregnated with three synergistic antibiotics, including rifampicin, clindamycin, and trimethoprim, to improve the antibacterial property.

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