scholarly journals High-Dosage Cefazolin Achieves Sufficient Cerebrospinal Diffusion To Treat an External Ventricular Drainage-Related Staphylococcus aureus Ventriculitis

2018 ◽  
Vol 63 (2) ◽  
pp. e01844-18 ◽  
Author(s):  
Matthieu Grégoire ◽  
Benjamin Gaborit ◽  
Colin Deschanvres ◽  
Raphaël Lecomte ◽  
Guillaume Deslandes ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cerebrospinal Fluid ◽  
Continuous Infusion ◽  
External Ventricular Drainage ◽  
High Dose ◽  
Ventricular Drainage ◽  
Content Type

ABSTRACT A patient received continuous infusion of cefazolin 10 g then 8 g daily for an external ventricular drainage-related methicillin-susceptible Staphylococcus aureus (MSSA) ventriculitis. Median free concentrations in the cerebrospinal fluid were 11.9 and 6.1 mg/liter after 10- and 8-g doses, respectively. Free concentrations in the cerebrospinal fluid were always above the MIC usually displayed by methicillin-susceptible Staphylococcus aureus (MSSA) isolates. These results support the use of high-dose cefazolin to achieve sufficient meningeal concentrations.

Cerebrospinal fluid antibiotic levels during treatment of shunt infections

1980 ◽  
Vol 52 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Steven L. Wald ◽  
Robert L. McLaurin
Keyword(s):  
Cerebrospinal Fluid ◽  
Inhibitory Concentration ◽  
External Ventricular Drainage ◽  
Cerebrospinal Fluid Shunt ◽  
Ventricular Drainage ◽  
Antibiotic Concentration ◽  
Content Type ◽  
Intraventricular Injections ◽  
Shunt Infections ◽  
Fine Print

✓ Twenty patients with documented cerebrospinal fluid shunt infections were treated with daily intraventricular injections of methicillin, cephalothin, or gentamicin without removal of the shunt or external ventricular drainage. Periodic determinations of intraventricular antibiotic concentration revealed significant levels in relation to the established minimum inhibitory concentration in all cases.

scholarly journals In VitroActivities of Daptomycin-, Vancomycin-, and Teicoplanin-Loaded Polymethylmethacrylate against Methicillin-Susceptible, Methicillin-Resistant, and Vancomycin-Intermediate Strains of Staphylococcus aureus

2011 ◽  
Vol 55 (12) ◽  
pp. 5480-5484 ◽  
Author(s):  
Yuhan Chang ◽  
Wen-Chien Chen ◽  
Pang-Hsin Hsieh ◽  
Dave W. Chen ◽  
Mel S. Lee ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
High Performance ◽  
Low Dose ◽  
Antibacterial Activities ◽  
High Dose ◽  
Bone Cements ◽  
Antibacterial Effects ◽  
Methicillin Resistant ◽  
Content Type

ABSTRACTThe objective of this study was to evaluate the antibacterial effects of polymethylmethacrylate (PMMA) bone cements loaded with daptomycin, vancomycin, and teicoplanin against methicillin-susceptibleStaphylococcus aureus(MSSA), methicillin-resistantStaphylococcus aureus(MRSA), and vancomycin-intermediateStaphylococcus aureus(VISA) strains. Standardized cement specimens made from 40 g PMMA loaded with 1 g (low-dose), 4 g (middle-dose) or 8 g (high-dose) antibiotics were tested for elution characteristics and antibacterial activities. The patterns of release of antibiotics from the cement specimens were evaluated usingin vitrobroth elution assay with high-performance liquid chromatography. The activities of broth elution fluid against differentStaphylococcus aureusstrains (MSSA, MRSA, and VISA) were then determined. The antibacterial activities of all the tested antibiotics were maintained after being mixed with PMMA. The cements loaded with higher dosages of antibiotics showed longer elution periods. Regardless of the antibiotic loading dose, the teicoplanin-loaded cements showed better elution efficacy and provided longer inhibitory periods against MSSA, MRSA, and VISA than cements loaded with the same dose of vancomycin or daptomycin. Regarding the choice of antibiotics for cement loading in the treatment ofStaphylococcus aureusinfection, teicoplanin was superior in terms of antibacterial effects.

Resolution of brain edema in severe brain injury at controlled high and low intracranial pressures

1984 ◽  
Vol 61 (4) ◽  
pp. 707-712 ◽  
Author(s):  
Meihong Cao ◽  
He Lisheng ◽  
Sun Shouzheng
Keyword(s):  
Cerebrospinal Fluid ◽  
Brain Injury ◽  
Brain Edema ◽  
External Ventricular Drainage ◽  
Blue Dye ◽  
Severe Brain Injury ◽  
Content Type ◽  
Intracranial Pressures ◽  
Low Levels ◽  
Cerebrospinal Fluid Protein

✓ A series of 87 patients with severe brain injury were studied. Intracranial pressure (ICP) monitoring and external ventricular drainage were used to control ICP at high and low levels. Clearance of ytterbium-169-labeled diethylenetriaminepentaacetic acid (169Yb-DTPA), Evans blue dye, and ventricular cerebrospinal fluid protein was measured at the two ICP levels over consecutive periods of 4 hours to confirm clearance of brain edema. The results support the hypothesis that brain edema is in part absorbed in the cerebrospinal fluid via transventricular flow.

External Ventricular Drainage

2018 ◽  
pp. 165-172
Author(s):  
Nitin Agarwal ◽  
Andrew F. Ducruet
Keyword(s):  
Traumatic Brain Injury ◽  
Cerebrospinal Fluid ◽  
Neurological Disease ◽  
External Ventricular Drain ◽  
Management Strategies ◽  
External Ventricular Drainage ◽  
Postoperative Management ◽  
Ventricular Drainage ◽  
Cerebrospinal Fluid Diversion ◽  
Lumbar Drain

External ventricular drainage, or ventriculostomy, refers to surgical placement of a catheter into the ventricle to achieve temporary cerebrospinal fluid diversion and remains one of the most frequently performed neurosurgical interventions. External ventricular drainage is an essential therapeutic strategy for a myriad of neurological disease processes causing hydrocephalus or increased intracranial pressure including traumatic brain injury, subarachnoid hemorrhage, and intracranial hemorrhage with intraventricular extension. In select cases, lumbar drains may provide a suitable alterative to an external ventricular drain (EVD). Complications related to both EVD and lumbar drain placement include malfunction, infection, and hemorrhage. This chapter reviews the indications, surgical technique, postoperative management strategies, and potential complications associated with external ventricular drainage.

scholarly journals Daptomycin-Nonsusceptible Vancomycin-Intermediate Staphylococcus aureus Vertebral Osteomyelitis Cases Complicated by Bacteremia Treated with High-Dose Daptomycin and Trimethoprim-Sulfamethoxazole

2012 ◽  
Vol 56 (11) ◽  
pp. 5990-5993 ◽  
Author(s):  
Lisa M. Avery ◽  
Molly E. Steed ◽  
Ashley E. Woodruff ◽  
Muhammad Hasan ◽  
Michael J. Rybak
Keyword(s):  
Staphylococcus Aureus ◽  
Bactericidal Activity ◽  
Vertebral Osteomyelitis ◽  
Clinical Isolates ◽  
High Dose ◽  
Content Type ◽  
Post Hoc

ABSTRACTWe report two cases of daptomycin (DAP)-nonsusceptible (DNS) vancomycin-intermediateStaphylococcus aureus(VISA) vertebral osteomyelitis cases complicated by bacteremia treated with high-dose daptomycin and trimethoprim-sulfamethoxazole. Both patients responded rapidly and favorably to this combination. The clinical isolates from the two patients were testedpost hocin anin vitropharmacokinetic/pharmacodynamic (PK/PD) model to confirm the bactericidal activity and enhancement of daptomycin and trimethoprim-sulfamethoxazole. The combination of high-dose daptomycin and trimethoprim-sulfamethoxazole should be explored further for the treatment of DNS VISA strains.

Telemetric ICP monitoring after surgery for posterior fossa and third ventricular tumors

1984 ◽  
Vol 60 (3) ◽  
pp. 649-651 ◽  
Author(s):  
Paul H. Chapman ◽  
Eric Cosman ◽  
Michael Arnold
Keyword(s):  
Posterior Fossa ◽  
External Ventricular Drainage ◽  
Ventricular Catheter ◽  
Ventricular Drainage ◽  
Icp Monitoring ◽  
Pressure Monitoring ◽  
Content Type ◽  
Clinical Observations ◽  
Ventricular Tumors ◽  
Fine Print

✓ After surgery for posterior fossa or third ventricular tumors, hydrocephalus may persist or evolve. Proper management of this complication requires timely detection. Temporary external ventricular drainage has been suggested by some authors as an adjunct to clinical observations and radiographic studies for unshunted patients. As an alternative, the authors have used a telemetric method of pressure monitoring in association with a ventricular catheter and subcutaneous reservoir. This has been found useful in eight patients without the disadvantages inherent in other methods of management.

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