Treatment of cerebrospinal fluid shunt infections with teicoplanin

  • M. L. Fernández Guerrero
  • M. de Górgolas
  • R. Fernández Roblas
  • J. María Campos
Notes

Abstract

Intraventricular teicoplanin 10–15 mg was administered daily to three patients with cerebrospinal fluid (CSF) shunt infections due toStaphylococcus epidermidis andEnterococcus faecalis. Teicoplanin concentrations in CSF 24 h after intrathecal injection of the drug exceeded four- to eight-fold the MICs for the infecting microorganisms. CSF cultures rapidly became negative and shunt devices were withdrawn and replaced in the same operative procedure. Intraventricular teicoplanin was well tolerated. No relapses occurred. Teicoplanin may be an alternative to vancomycin for the antimicrobial therapy of CSF shunt infections.

Keywords

Internal Medicine Operative Procedure Cerebrospinal Fluid Vancomycin Antimicrobial Therapy 

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References

  1. 1.
    Schoenbaum SC, Gardner P, Shillito J Infections of cerebrospinal fluid shunts: epidemiology, clinical manifestations and therapy. Journal of Infectious Diseases 1975, 131: 543–552.PubMedGoogle Scholar
  2. 2.
    McLaurin RL, Frame PT Treatment of infections of cerebrospinal fluid shunts. Reviews of Infectious Diseases 1987, 9: 595–603.PubMedGoogle Scholar
  3. 3.
    Frame PT, McLaurin RL Treatment of CSF shunt infections with intrashunt plus oral antibiotic therapy. Journal of Neurosurgery 1984, 60: 354–360.PubMedGoogle Scholar
  4. 4.
    Bibler MR, Frame PT, Hagler DN, Bode RB, Staneck JL, Thamlikitkul V, Harris JE, Haregewoin A, Bullock WE Clinical evaluation of efficacy, pharmacokinetics, and safety of teicoplanin for serious gram-positive infections. Antimicrobial Agents and Chemotherapy 1987, 31: 207–212.PubMedGoogle Scholar
  5. 5.
    Glupczynnski Y, Lagast H, Van der Auwera P, Thys JP, Crokaert F, Yourassowsky E, Meunier-Carpentier F, Klastersky J Clinical evaluation of teicoplanin for therapy of severe infections caused by gram-positive bacteria. Antimicrobial Agents and Chemotherapy 1986, 29: 52–57.PubMedGoogle Scholar
  6. 6.
    Lalla F, Santoro D, Rinaldi E, Suter F, Cruciani M, Gaglianone MH, Rizzardini G, Pellegata G Teicoplanin in the treatment of infections by staphylococci,Clostridium difficile and other gram-positive bacteria. Journal of Antimicrobial Chemotherapy 1989, 23: 131–142.Google Scholar
  7. 7.
    Calain P, Krause KH, Vaudaux P, Auckenthaler R, Lew D, Waldvogel F, Hirschel B Early termination of a prospective, randomized trial comparing teicoplanin and flucloxacillin for treating severe staphylococcal infection. Journal of Infectious Diseases 1987, 155: 187–191.PubMedGoogle Scholar
  8. 8.
    Stahl JP, Croize J, Wolff M, Garaud JJ, Leclerq F, Vachon F, Micoud M Poor penetration of teicoplanin into cerebrospinal fluid in patients with bacterial meningitis. Journal of Antimicrobial Chemotherapy 1987, 20: 141–142.PubMedGoogle Scholar
  9. 9.
    Maserati R, Cruciani M, Azzini M, Carnevale C, Suter F, Concia E Teicoplanin in the therapy of staphylococcal neuroshunt infections. International Journal of Clinical and Pharmacologic Research 1987, 7: 207–213.Google Scholar
  10. 10.
    Venditi M, Micozzi A, Serra P, Buniva G, Palma L, Martino P Intraventricular administration of teicoplanin in shunt associated ventriculitis caused by methicillin-resistantStaphylococcus aureus. Journal of Antimicrobial Chemotherapy 1988, 21: 513–515.PubMedGoogle Scholar
  11. 11.
    Cruciani M, Navarra A, DiPerri G, Andreoni M, Danzi MC, Concia E, Bassetti D Evaluation of intraventricular teicoplanin for the treatment of neurosurgical shunt infections. Clinical Infectious Diseases 1992, 15: 285–289.PubMedGoogle Scholar

Copyright information

© Friedr. Vieweg & Sohn Verlagsgesellschaft mbH 1994

Authors and Affiliations

  • M. L. Fernández Guerrero
    • 1
  • M. de Górgolas
    • 1
  • R. Fernández Roblas
    • 1
  • J. María Campos
    • 1
  1. 1.Division of Infectious Diseases and Neurosurgery, Fundación Jiménez DíazUniversidad Autónoma de MadridMadridSpain

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