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\s=b\Five children with intraventricular shunts developed ventriculitis due to organisms resistant to multiple antimicrobial agents but sensitive to gentamicin sulfate. No gentamicin was detected in ventricular CSF of four patients at a time when gentamicin was being administered only intravenously. The intraventricular administration of 1 mg of gentamicin resulted in ventricular CSF concentrations greater than 20 \g=m\g/ml one hour and 5 to 14 \g=m\g/ml 36 hours after administration. Patients were treated with intraventricularly given gentamicin for an average of 16 days, with no apparent complications or relapses during the 12-to 24\ x=req-\ month follow-up period. Intraventricularly administered gentamicin sulfate (1 mg every 24 to 36 hours) in conjunction with complete shunt removal was an effective means of therapy of ventriculitis caused by bacteria resistant to antibiotics that readily penetrate the blood-brain barrier.(Am J Dis Child 132: [480][481][482][483] 1978) Compl i cati ons of ventriculostomy procedures performed for diver¬ sion of ventricular cerebrospinal fluid to other sites include shunt infections, which occur in approximately 27% of patients.1 The majority of these infec¬ tions are caused by Staphylococcus epidermidis and occur within three months after the operative proce¬ dure.-Treatment of patients with infected shunts includes removal of the foreign body and administration of antimicrobial agents1 -tailored spe¬ cifically to the offending organism and host involved. If ventriculitis complicates shunt infection, and the offending pathogen is sensitive only to antibiotics that diffuse poorly into the cerebrospinal fluid, parenteral therapy may not be sufficient to afford a cure. We prospectively evaluFrom the Program in

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