Evaluation of intraventricular teicoplanin for the treatment of neurosurgical shunt infections

Clin Infect Dis. 1992 Aug;15(2):285-9. doi: 10.1093/clinids/15.2.285.

Abstract

Seven patients with staphylococcal neurosurgical shunt infections were treated with intraventricular teicoplanin. Two infants received 5 mg/d, three patients received 20 mg/d, and two patients received 20 mg every other day. Six of these patients also received intravenous antibiotics. Three patients had infections caused by methicillin-susceptible Staphylococcus epidermidis, and one patient had an infection caused by methicillin-resistant S. epidermidis. Three patients were infected with Staphylococcus aureus (one with a methicillin-resistant strain and two with methicillin-susceptible strains). The mean duration of intraventricular therapy was 16 days. Sterilization of cerebrospinal fluid (CSF) was obtained after an average of 4.4 days. All patients were cured both clinically and microbiologically. No significant adverse effects were observed in any patients. Penetration of teicoplanin into the CSF after intravenous administration was poor. However, after intraventricular administration, high and prolonged peak and trough levels of teicoplanin were detected in the CSF. Bactericidal activity of the CSF was remarkable, exceeding the 1:8 dilution in the majority of the cases. The alternate-day schedule of intraventricular administration of teicoplanin was as effective as the once-daily regimen.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / cerebrospinal fluid
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Infections / cerebrospinal fluid
  • Bacterial Infections / drug therapy*
  • Cerebrospinal Fluid / microbiology
  • Cerebrospinal Fluid Shunts / adverse effects*
  • Female
  • Follow-Up Studies
  • Glycopeptides / adverse effects
  • Glycopeptides / cerebrospinal fluid
  • Glycopeptides / therapeutic use
  • Gram-Positive Bacteria / drug effects*
  • Humans
  • Infant
  • Injections, Intraventricular
  • Male
  • Middle Aged
  • Teicoplanin

Substances

  • Anti-Bacterial Agents
  • Glycopeptides
  • Teicoplanin