Intra-cerebrospinal fluid antibiotics to treat central nervous system infections: A review and update

Oliver D. Mrowczynski, Sara T. Langan, Elias Rizk

Research output: Contribution to journalReview article

Abstract

Central nervous system infections can be complications of neurosurgical procedures or can occur spontaneously, and occasionally lead to devastating neurological complications, increased rate of mortality, and lengthier stays in the hospital, subsequently increasing costs. The use of intrathecal antibiotics to bypass the blood brain barrier and provide effective concentrations to the central nervous system has been described as an adjunct treatment option. However, the regimens of antibiotics utilized intrathecally have not been standardized. Our review of the literature included all articles from MEDLINE/PubMed and Ovid from inception to 2017 and after removing duplicates and checking for relevancy, the final number of articles yielded was 200. This review summarizes the use of antibiotics intrathecally to treat CNS infections, the dosages, therapeutic efficacies, and highlights significant side effects. The current rates of mortality in patients suffering from CNS infections is high, thus intrathecal antibiotic therapy should be considered as a potential therapeutic strategy in this patient population. Multiple antibiotics have demonstrated safety and efficacy when used intrathecally, and further studies, including clinical trials, need to be performed to elucidate their full therapeutic potential and outline proper dosing regimens.

Original languageEnglish (US)
Pages (from-to)140-158
Number of pages19
JournalClinical Neurology and Neurosurgery
Volume170
DOIs
StatePublished - Jul 1 2018

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Central Nervous System Infections
Cerebrospinal Fluid
Anti-Bacterial Agents
Neurosurgical Procedures
Therapeutics
Mortality
Infection
Blood-Brain Barrier
PubMed
MEDLINE
Length of Stay
Central Nervous System
Clinical Trials
Safety
Costs and Cost Analysis
Population

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

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Intra-cerebrospinal fluid antibiotics to treat central nervous system infections : A review and update. / Mrowczynski, Oliver D.; Langan, Sara T.; Rizk, Elias.

In: Clinical Neurology and Neurosurgery, Vol. 170, 01.07.2018, p. 140-158.

Research output: Contribution to journalReview article

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AU - Rizk, Elias

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AB - Central nervous system infections can be complications of neurosurgical procedures or can occur spontaneously, and occasionally lead to devastating neurological complications, increased rate of mortality, and lengthier stays in the hospital, subsequently increasing costs. The use of intrathecal antibiotics to bypass the blood brain barrier and provide effective concentrations to the central nervous system has been described as an adjunct treatment option. However, the regimens of antibiotics utilized intrathecally have not been standardized. Our review of the literature included all articles from MEDLINE/PubMed and Ovid from inception to 2017 and after removing duplicates and checking for relevancy, the final number of articles yielded was 200. This review summarizes the use of antibiotics intrathecally to treat CNS infections, the dosages, therapeutic efficacies, and highlights significant side effects. The current rates of mortality in patients suffering from CNS infections is high, thus intrathecal antibiotic therapy should be considered as a potential therapeutic strategy in this patient population. Multiple antibiotics have demonstrated safety and efficacy when used intrathecally, and further studies, including clinical trials, need to be performed to elucidate their full therapeutic potential and outline proper dosing regimens.

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