Outcomes in meningitis‑ventriculitis treated with intravenous or intrathecal plus intravenous colistin: A meta‑analysis.

Abstract

The aim of the present meta-analysis was to provide further evidence on the management of bacterial ventriculitis or meningitis (BVM) and to compare the efficacy of intravenous (IV) or intravenous plus intrathecal (IV/ITH) treatment with colistin. The present meta-analysis included full-text articles published between 1980 and 2020 that compared outcomes in meningitis-ventriculitis treated with IV or IV/ITH colistin. The collected variables included the first author's name, country, study period covered, publication year, the total number of patients and follow-up, Glasgow Coma Scale score upon admission, treatment duration, Acute Physiological and Chronic Health Evaluation II score, the length of intensive unit (ICU) stay, treatment efficacy and mortality for both groups. To avoid publication bias, the final aim was to collect a homogenous pool of manuscripts, including only articles that compared only two modalities. After applying all exclusion and inclusion criteria, seven of 55 articles were left in the final article pool. The total number of patients in those seven articles was 293, divided into two groups (186 in the IV and 107 in the IV/ITH group). As regards ICU stay and mortality, the findings illustrated a statistically significant difference between the two groups. On the whole, the findings of the present study support the addition of ITH colistin to its IV administration for the effective treatment of BVM.