Antibiotic therapy by intrathecal or intraventricular approach for postsurgical meningitis or ventriculitis: a systematic review and meta-analysis.

Objective: To systematically review the evidence for intrathecal or intraventricular plus intravenous administration of antibiotics compared with standard management for postsurgical meningitis or ventriculitis. Methods: The following databases were searched: MEDLINE, the Central Register of Controlled Trials (CENTRAL); PubMed, EMBASE; and reference list of articles. Results: Administration of intrathecal/intraventricular antibiotics was associated with decreased mortality (OR 0.27 [95% CI 0.15–0.49] p = < 0.00001), increased cure rate (OR 3.4 [95% CI 1.6–7.22] p = 0.001). There was no difference in the occurrence of reinfection rate, and in poor functional outcome (OR 0.57 [95% CI 0.21–1.60] p = 1.6 p = 0.29; OR 0.43 [95% CI 0.11–1.68] p = 0.22). Conclusions: Intrathecal/intraventricular plus intravenous administration of antibiotics improves survival and cure rate in patients with postoperative meningitis or ventriculitis. More high-quality studies are needed. [ABSTRACT FROM AUTHOR]

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