Infected CNS infusion pumps. Is there a chance for treatment without removal?

Efstathios J. Boviatsis, A. T. Kouyialis, I. Boutsikakis, S. Korfias, D. E. Sakas, R. A. Johnston, Roger Bayston

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background. Intrathecal baclofen administration by means of an implantable pump is nowadays a safe and effective method in the treatment of spasticity. One of the rare but devastating complications of this technique is pump infection, with a variety of Gram (-) and Gram (+) organisms being involved. Treatment of these infections, according to international literature, requires removal of the device and appropriate antibiotic therapy. Method. This article reports the authors experience in treating 3 patients with severe, medically intractable spasticity, suffering from infection of the intrathecally-delivering pump. A decision was made not to replace the device, but to treat this complication with pump disinfection and with a new treatment modality that has never been used before, the intra-pocket administration of antibiotics. Findings. In all cases the infection was eradicated and the integrity of the pump maintained. None of the patients required a procedure under general anesthesia. Conclusions. Removal should no longer be considered the first treatment option in infections of intrathecally delivering pumps, especially those due to non-adherent bacteria, with mild clinical symptomatology. An initial attempt should always be made for conservative treatment. Intra-pocket administration of antibiotics helps in achieving high drugs levels locally, and may prove an important element in our armamentarium against such infections.

Original languageEnglish
Pages (from-to)463-467
Number of pages5
JournalActa Neurochirurgica
Volume146
Issue number5
DOIs
Publication statusPublished - May 2004

Keywords

  • Baclofen
  • Infection
  • Intrathecal infusion
  • Pump

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    Boviatsis, E. J., Kouyialis, A. T., Boutsikakis, I., Korfias, S., Sakas, D. E., Johnston, R. A., & Bayston, R. (2004). Infected CNS infusion pumps. Is there a chance for treatment without removal? Acta Neurochirurgica, 146(5), 463-467. https://doi.org/10.1007/s00701-004-0217-4