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Japanese

INTRATHECAL GENTAMICIN IN THE TREATMENT OF MENINGITIS : CLINICAL CASE STUDY Susumu Wakai 1 , Hiroshi Mizutani 1 , Nobuhiko Aoki 1 , Masaru Kubota 2 1Department of Neurosurgery, University of Tokyo 2Neurosurgical Department of Fuchu Municipal Hospital of Metropolitan Tokyo pp.1227-1232
Published Date 1978/11/1
DOI https://doi.org/10.11477/mf.1406204336
  • Abstract
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The authors report 33 cases of meningitis treated with intrathecally administered gentamicin (GM) and examine it's effectiveness for meningitis, side effects and optimum dose. Of 33 cases 15 cases (group I) were treated with GM alone, 7 cases (group IIa) with GM combined with SB-PC or CP. In 8 cases of the other 11 cases (group IIb) GM was changed for SB-PC or CP because of it's in-efficiency and side effects (6 cases) and other reasons (2 cases). In the remaining three cases of groupIIb SB-PC or CP was changed for GM due to their inefficiency. Maximum intrathecal dose is shown below: 4mg-7 cases, 8mg-5 cases, 10mg-15 cases, 20mg-4 cases, 40mg-2 cases. In all cases GM was not administered systemically, but each of CP, CB-PC, SB-PC and TC was administered systemically.

In group I, only one case died of G-I tract bleeding but the others were cured. In group Ha all but one case was cured. In group IIb one case of cryptococcosis was dead. Total effective cases of intrathecal GM were 17 of 24 cases excluding group Ha (7 cases) and 3 cases of group fib. There was no side effect in cases of which maximum dose was 4-20 mg, but in one of 40 mg administered cases in which GM was injected from cisternal puncture hearing, vestibular and visual function were disturbed permanently. Therefore GM should not be injected into the cistern.

In our conclusion intrathecal GM is thought to be effective in the treatment of meningitis without systemic GM. Effective optimum dose is 4-8mg/ day in adult and if ineffective after 7-10 days GM should be changed for other antibiotics.


Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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