Intraventricular and Intravenous Tobramycin with Ceftazidime for Ventriculitis Secondary to Pseudomonas aeruginosa

Abstract

The preferred method for shunting cerebrospinal fluid in the ventricles is via a ventriculoperitoneal or ventriculoatrial shunt. Unfortunately, infection is a major complication of shunt surgery, which places the patient at risk of intellectual impairment and death. Although the most common causative pathogens are Staphylococcus epidermidis and Staphylococcus aureus , gram-negative bacterial infections have increased over the last three decades. Treatment of Pseudomonas ventriculitis is highly variable, because there are few guidelines for drug selection, administration, and monitoring. We report a case of post-shunt revision Pseudomonas meningitis/ ventriculitis that was successfully treated by the intraventricular adminstration tobramycin in conjunction with intravenous tobramycin and ceftazidime.