на форуме таких специалистов нет, как ведут инфекцию за рубежом у таких пациентов на английском:
Initial empiric therapy should be broad-spectrum, with appropriate coverage for resistant Gram-negative pathogens, including cefepime, ceftazidime, or meropenem. While it can be used for patients allergic to beta-lactam antibiotics, intravenous meropenem is recommended due to its lower risk of seizures compared to imipenem, and clinical studies have shown its benefit in the empirical treatment of bacterial meningitis. Once Gram-negative organisms are identified, antibiotics can be switched to pathogen-specific therapy. In patients who cannot tolerate or have contraindications to carbapenems, aztreonam or ciprofloxacin may be used as alternatives.
In addition to antibiotic administration, the removal of the infected VPS is crucial for the rapid eradication of infectious pathogens, as certain microorganisms, such as P. aeruginosa, have the potential to adhere to and form biofilms on the catheter. This was demonstrated in a study where the removal of all infected internal ventricular catheter components, along with targeted antimicrobial therapy, was effective in 85% of patients. In certain clinical cases, the evaluation of CSF analysis, culture results, and the treatment of hydrocephalus, as well as the insertion of a temporary external ventricular conduit, may be considered before replacing the long-term VPS.
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