Aminoglycoside therapy of gram-negative bacillary meningitis.
The distribution of aminoglycosides in the cerebrospinal fluid (CSF) space was examined after intralumbar, intraventricular, and systemic administration during seven episodes of gram-negative bacillary meningitis. Six episodes were associated with culture proved ventriculitis. Parenteral therapy with gentamicin or tobramycin produced low concentrations  of aminoglycoside (less than 1.0 mug/ml) in the lumbar, ventricular, and cisternal CSF. Administration of 5 to 10 mg of aminoglycoside into the lumbar intrathecal space resulted in 27-81 mug/ml in the lumbar CSF, but 0-2.1 mug/ml in the ventricular CSF. In contrast, aminoglycoside administered into the cerebral ventricles produced concentrations in the lumbar CSF of 11.5-27.5 mug/ml and ventricular CSF of 12.8-40 mug/ml. All six episodes treated via the ventricular route resulted in a bacteriologic cure. Intraventricular administration of aminoglycosides offers a reliable means of achieving high aminoglycoside concentrations throughout the subarachnoid space.
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy*; D002552:Cerebral Ventricles; D002648:Child; D004927:Escherichia coli Infections / Q000188:drug therapy; D005839:Gentamicins / Q000008:administration & dosage* / Q000134:cerebrospinal fluid / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D007278:Injections, Spinal; D007710:Klebsiella Infections / Q000188:drug therapy; D008161:Lumbosacral Region; D008581:Meningitis / Q000188:drug therapy*; D011552:Pseudomonas Infections / Q000188:drug therapy; D014031:Tobramycin / Q000008:administration & dosage* / Q000134:cerebrospinal fluid / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D014031:Tobramycin