Improving the role of intraventricular antimicrobial agents in the  management of meningitis.
OBJECTIVE
The aim is to review the role of intraventricular administration of antimicrobial agents in the treatment of patients with bacterial and fungal meningitis.


RESULTS
This article discusses indications for intraventricular antimicrobial agents, choice of antibiotics, strategies to monitor pharmacokinetics of central nervous system compartments and unanswered issues for this management approach.


CONCLUSIONS
Intraventricular administration of antimicrobials may be necessary in certain difficult- to- eradicate central nervous system infections. There is a significant need for clinical trials and management guidelines in this area.
Ziai
Wendy C
WC
Division of Neurosciences Critical Care, Department of Neurology and Anesthesiology-Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA. weziai@jhmi.edu
Lewin
John J
JJ
D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002552:Cerebral Ventricles / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy; D006801:Humans; D007276:Injections, Intraventricular; D016920:Meningitis, Bacterial / Q000188:drug therapy*; D008826:Microbial Sensitivity Tests; D017410:Practice Guidelines as Topic
D000890:Anti-Infective Agents