Prophylactic antibiotics with intracranial pressure monitors and external ventricular drains: a review of the evidence

Prabhu, Vikram C.; Kaufman, Howard H.; Voelker, Joseph L.; Aronoff, Stephen C.; Niewiadomska-Bugaj, Magdalena; Mascaro, Suzy; Hobbs, Gerald R.

doi:10.1016/s0090-3019(99)00084-1

Cited by 57 publications

(37 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Immediate removal of the catheter led to complete reconstitution. Considering a 95% confidence interval of 0-6% for the PCV group and of 0-22% for the OP-ICP group, the results of this study match the results published thus far with respect to the frequency of infections during ventricular catheter placement [5,23,24]. In contrast to the OP-ICP group, catheter placement within the PCV group was successful in all cases, and due to the extensive disinfection measures taken before the intervention, there were no periprocedural infections.…”

Section: Discussionsupporting

confidence: 84%

“…The infection rates associated with the implantation of intracranial ventricular catheters and intraparenchymatous pressure-monitoring devices amounts to up to 0-27% of patients depending on the author of the study [5,23,24]. In this study 1 patient of the control group (OP-ICP) developed ventriculitis 4 days following the implantation of the catheter (7.7%).…”

Section: Discussionmentioning

confidence: 76%

See 1 more Smart Citation

Evaluation of minimally invasive percutaneous CT-controlled ventriculostomy in patients with severe head trauma

et al. 2004

View full text Add to dashboard Cite

Evaluation of percutaneous CT-controlled ventriculostomy (PCV) in patients with severe traumatic brain injury to measure intracranial pressure as a component of early clinical care. A consecutive series of 52 interventions with PCV was prospectively analyzed with regard to technical success, procedural time, time from the initial cranial computed tomography (CCT) until procedure and transfer to the intensive care unit (ICU). Additionally, the data was compared with a retrospective control group of 12 patients with 13 procedures of conventional burr-hole ventriculostomy (OP-ICP). The PCV was successful in all cases (52 of 52; 95% CI 94-100%). In 1 case a minor hemorrhage into the ipsilateral lateral ventricle was observed on CT scans due to an initially unsuccessful puncture (95% CI 0-6%). No infections occurred (95% CI 0-6%). In the control group with OP-ICP one catheter infection and one unsuccessful catheter placement occurred (each 8%, 95% CI 0-20%). The PCV led to a significant decrease of procedure time from 45 +/- 11 min (OP-ICP) to 20 +/- 12 min (PCV). The interval from the initial CCT until procedure (PCV 28 +/- 11 min, OP-ICP 78 +/- 33 min) and transfer to the ICU (PCV 69 +/- 34 min, OP-ICP 138 +/- 34 min) could also be significantly reduced (each with p<0.05, Mann-Whitney U-test). Percutaneous CT-controlled ventriculostomy is a safe and efficient method for ICP catheter placement during initial trauma room management. It significantly reduces the time of initial trauma room treatment.

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 76%

Evaluation of minimally invasive percutaneous CT-controlled ventriculostomy in patients with severe head trauma

et al. 2004

View full text Add to dashboard Cite

show abstract

“…The duration of an EVD as a potential risk factor is still being discussed [8]. We established a significant correlation between the longer duration of an EVD and the higher infection rate.…”

Section: Discussionmentioning

confidence: 63%

“…The most frequently found microorganisms are Gram-positive bacteria, nevertheless we found certain contradictions in the literature [5,7,8].…”

Section: Introductionmentioning

confidence: 65%

Infections of external ventricular drainages

Strojnik¹,

Golc

Zakelšek

2013

Open Medicine

View full text Add to dashboard Cite

show abstract

“…Otras indicaciones potenciales incluyen el tratamiento de una infección asociada a un drenaje ventricular cuando no es posible plantear su retiro o reemplazo. La eficacia del uso profiláctico de antimicrobianos intratecales en presencia de un drenaje ventricular, no ha sido claramente demostrado 65,66 . Un resumen de los aspectos comentados en esta publicación se entrega en la Tabla 4.…”

Section: Indicaciones Potenciales De Antimicrobianos Intratecalesunclassified

Antibióticos intratecales en pacientes adultos

2003

Rev. chil. infectol.

View full text Add to dashboard Cite

IntroducciónLos antimicrobianos administrados por vía intratecal son necesarios en algunas infecciones del sistema nervioso central (SNC) para proveer, en un medio carente de mecanismos fagocíticos, concentraciones bactericidas de compuestos que tienen una baja penetración por la barrera hematoencefálica.La administración intratecal considera la administración intralumbar o intraventricular de medicamentos y no reemplaza la terapia sistémica para controlar la infección fuera del SNC.Los compuestos intratecales más utilizados corresponden a aminoglucósidos y vancomicina debido a la existencia y emergencia de infecciones asociadas a bacilos Gram negativos o cocáceas Gram positivas resistentes. Estos procesos incluyen meningitis o ventriculitis, en general de carácter nosocomial y asociadas a procedimientos neuroquirúrgicos y/o derivaciones ventriculares externas o internas. Las intervenciones quirúrgicas para efectuar un drenaje del LCR en pacientes con hidrocefalia hipertensiva se han expandido progresivamente en el país y las complicaciones infecciosas agregan una morbilidad o mortalidad considerable, de allí la relevancia de conocer esta forma terapéutica. Este documento trata especialmente de las ventriculitis e infecciones asociadas a drenajes ventriculares externos. Aspectos diagnósticos de las ventriculitisEl diagnóstico de ventriculitis asociada a un drenaje ventricular no ha sido estandarizado. El espectro de alternativas incluye un cultivo del Increase of ventriculitis rates associated to CNS shunts that involve multiresistant microorganisms has made relevant this route of administration due to the limited penetration of antibiotics active against multiresistant organisms through the blood brain barrier. Aminoglycosides and vancomycin are the most common antibiotics used for this purpose. In order to accomplish bactericidal activity and due to its concentration-dependent mechanism, aminoglycosides should reach concentrations 8 to 10 times above the MIC of a given Gram negative bacilli. Doses of 2 to 5 mg for gentamicin and 30 mg for amikacin every 24 h allow this purpose and has been associated to clinical cure in several reports. Vancomycin attains its bactericidal activity by a time-dependent mechanism and the best predictor of clinical efficacy is the time area under the curve (AUC) above the MIC. Doses of 20 mg every day assure an adequate temporal exposition to the drug if trough concentrations of 5 to 10 µg/ml are obtained, and have been related to clinical efficacy. Intrathecal concentrations for these antibiotics are higher and therapeutically effective when they are administered through intraventricular route than by intralumbar puncture. Intraventricular antibiotics are indicated when a patient affected by ventriculitis does not improve despite maximal-doses systemic antibiotic therapy and/or CSF remains positive for microorganisms. In order to secure efficacy, intraventricular antibiotics should be implemented with removal of the ventricular drain associated to infection. Experience with quinu...

show abstract

Prophylactic antibiotics with intracranial pressure monitors and external ventricular drains: a review of the evidence

Cited by 57 publications

References 87 publications

Evaluation of minimally invasive percutaneous CT-controlled ventriculostomy in patients with severe head trauma

Evaluation of minimally invasive percutaneous CT-controlled ventriculostomy in patients with severe head trauma

Infections of external ventricular drainages

Antibióticos intratecales en pacientes adultos

Contact Info

Product

Resources

About