Usefulness of intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis treatment

Abstract Introduction Cryptococcal meningitis is a severe infection among immunosuppressed individuals, with a high mortality rate. Although amphotericin B is the first-choice drug for treatment, its use is restricted when adverse effects are clinically problematic. The usefulness of intraventricula...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the neurological sciences 2015-11, Vol.358 (1), p.259-262
Main Authors: Nakama, Tatsuya, Yamashita, Satoshi, Hirahara, Tomoo, Okamoto, Sadahisa, Honda, Shoji, Watanabe, Masaki, Kimura, En, Uchino, Makoto, Yano, Shigetoshi, Kuratsu, Jun-ichi, Ando, Yukio
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Amphotericin B
Antifungal Agents - administration & dosage
Antifungal Agents - therapeutic use
Antifungal drugs
Cryptococcal meningitis
Cryptococcus neoformans
Drug Delivery Systems
Female
Humans
Intraventricular injection
Male
Meningitis, Cryptococcal - drug therapy
Middle Aged
Neurology
Ommaya reservoir
Outcome
Retrospective Studies
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Introduction Cryptococcal meningitis is a severe infection among immunosuppressed individuals, with a high mortality rate. Although amphotericin B is the first-choice drug for treatment, its use is restricted when adverse effects are clinically problematic. The usefulness of intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis treatment has been unconfirmed. We evaluated the efficacy of intraventricular infusion of amphotericin B through Ommaya reservoirs. Materials and methods We retrospectively analyzed 10 consecutive patients with cryptococcal meningitis who were refractory to systemic administration of antifungal drugs. Results Fever or nausea occurred in most patients. However, no patient complained of serious complications such as renal toxicity. Seven patients recovered completely or partially, whereas three patients died. Conclusions To establish the efficacy of the intraventricular infusion of antifungal drugs through Ommaya reservoirs for cryptococcal meningitis, a prospective investigation should be designed to compare those treated according to the updated guidelines and those treated with antifungal drugs through the Ommaya reservoirs.
ISSN:0022-510X
1878-5883
DOI:10.1016/j.jns.2015.09.005