The use of intrathecal antibiotics for bacterial meningitis: what evidence do we have?

Abstract

The treatment of meningitis is a complex issue when it comes to multi-resistant antibiotic (ATB) bacteria, limiting the drug options that can cross the blood-brain barrier and effectively reach the subarachnoid space. The impact on the effectiveness of the therapeutic arsenal available, due to the indiscriminate use of antibacterial on a global scale, increases the chances of therapeutic failure of the initial empirical treatment and a persistence of failure despite the culture of targeting the treatment at the pathogens, while not obtaining satisfactory results. Thus, the use of strategies to optimize the delivery of antibacterials to the pathology site involves using the pharmacokinetic mechanism in order to achieve the desired effect through intrathecal administration. During this review, we aimed to evaluate the use of intrathecal antibiotic therapy in patients infected with multidrug-resistant bacteria and analyze possible adverse effects.