Efficacy and safety of intrathecal meropenem and vancomycin in the treatment of postoperative intracranial infection in patients with severe traumatic brain injury

Zhang,Qiang; Chen,Hongxing; Zhu,Chao; Chen,Fangzhou; Sun,Suohui; Liang,Nan; Zheng,Wei

doi:10.3892/etm.2019.7503

Efficacy and safety of intrathecal meropenem and vancomycin in the treatment of postoperative intracranial infection in patients with severe traumatic brain injury

Authors:
- Qiang Zhang
- Hongxing Chen
- Chao Zhu
- Fangzhou Chen
- Suohui Sun
- Nan Liang
- Wei Zheng
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Affiliations: Emergency Department, Tai'an Traditional Chinese Medicine Hospital, Tai'an, Shandong 271000, P.R. China, Department of ICU, Affiliated Hospital of Taishan Medical University, Tai'an, Shandong 271000, P.R. China, Department of Neurosurgery, Affiliated Hospital of Taishan Medical University, Tai'an, Shandong 271000, P.R. China
Published online on: April 18, 2019 https://doi.org/10.3892/etm.2019.7503
Pages: 4605-4609
Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

This study investigated the improvement and safety of intrathecal meropenem and vancomycin in the treatment of postoperative intracranial infection in patients with severe traumatic brain injury (STBI). A retrospective analysis was performed on 86 patients with intracranial infections after cranial trauma operation in Tai'an Traditional Chinese Medicine Hospital and Affiliated Hospital of Taishan Medical University from May 2004 to June 2017. The patients were divided into the control group (43 patients) and the experimental group (43 patients) according to the treatment. Patients in the control group were intravenously infused with vancomycin hydrochloride (1.0 g, Q12H) and meropenem (2.0 g, Q8H). After lumbar cistern drainage was performed for the release of cerebrospinal fluid (CSF), patients in the experimental group were slowly given vancomycin 20 mg. After the tube was flushed with 2 ml of 0.9% sodium chloride injection, the patients were slowly given meropenem 20 mg, bid. The clinical efficacy, cure time and treatment cost of patients in the two groups were observed. The adverse reactions and sequelae after 6 months of treatment were recorded. The response rate (RR) of patients in the experimental group was significantly higher than that in the control group (P<0.05). The cure time of patients in the experimental group was significantly lower than that in the control group (P<0.05). The treatment cost of patients in the experimental group was significantly lower than that in the control group (P<0.05). The incidence of adverse reactions of patients, incidence of sequelae of patients in the experimental group was significantly lower than that in the control group (P<0.05). Intrathecal meropenem and vancomycin is more effective than intravenous administration in the treatment of intracranial infection after craniotomy. It can significantly shorten the treatment time and reduce the treatment cost, with better safety.

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