A Clinical Analysis Of Intracranial Infections After Craniotomy Treated With Intrathecal Vancomycin

Objective: To evaluate the clinical efficacy and safety of intrathecal Vancomycin in the treatment of intracranial infection after craniotomy.Methods: A retrospective study was made to 33 cases of intracranial infection after craniotomy in recent 2 years, 18 cases treated with intrathecal Vancomycin were divided into treatment group, and 15 cases treated with intravenous antibiotics were divided into control group. Compared the clinical efficacy, the period and cost spent to control the infection, and evaluated the sensitivity of Vancomycin against the germs which lead to the intracranial infections, the relations of intrathecal doses with therapeutic period and the CNS toxicity effect were also considered.Results: The sensitivity ratio of Vancomycin against etiologic agent in intracranial infections was 9 in 9(100%). In the treatment team, 16 cases were healed completely, 1 case was excellenced, 1 failed, while in control team, 8 cases were healed completely and 4 cases were excellenced, 1 was improved partly, 2 failed in which 1 died. Meanwhile the time of therapy was 16 days shorter after intrathecal Vancomycin, and the costs were about RMB6500 less for the treatment group. The clinical signs and symptoms of intracranial infection could be improved rapidly after intrathecal vancomycin administration. There was a relativity between the general doses of Vancomycin and monitoring parameters of intracranial infection such as WBC counts of CSF, glucose and protein value of CSF, (r=0.539,r=-0.594 r=0.551, P<0.05). Only 1 cases showed moderate CNS neurotoxic effects, and recovered in short time.Conclusion: Most of etiologic agents of intracranial infections are susceptible to Vancomycin, it showed perfect clinical efficacy and would shorten the costs and days for the control of infection, also no apparent neurotoxic effects are observed.