目的：鑒於臨床經驗與最新文獻有限，選擇腦室內給予抗生素的因素、預後及安全性仍未有定論，本研究目的在探討神經外科使用抗生素腦室內給藥的可能因素、療效與安全性。
方法：以回溯中國醫藥大學附設醫院電子病歷來進行案例系列研究，納入2018年1月1日 ~ 2020年2月29日期間於本院被確診腦膜炎或腦室炎且同時被處方抗生素腦室內治療的神經外科病人。所納入的病人分成aminoglycoside 組或後線抗生素組（colistin 及tigecycline）以比較治癒與副作用等及相關因素探討。
結果：9位病人中，aminoglycoside 組5人，後線抗生素組有4人（具抗藥性菌種）。除了aminoglycoside 組年齡全大於45歲而後線抗生素組僅1位（25%, p = 0.048），兩組腦室內給藥的治癒率、或神經、腎臟及肝臟藥品副作用以及前後感染表徵的比例並沒有統計上顯著的差異（所有p > 0.05）。
結論：經腦室內給予aminoglycoside 類或後線抗生素的治療效果及安全性並沒有差異。但接受後線抗生素腦室內給藥的病人似乎較年輕，推測與具抗藥性菌種且病情較嚴重有關。

Objective: Little is known about the factors, safety, and consequent outcomes of intraventricular antimicrobial therapy for meningitis or ventriculitis. This study explored the factors, effectiveness, and safety of intraventricular antimicrobial therapy for patients in neurosurgical units.
Methods: We implemented a case series study by reviewing the electronic medical records of the patients receiving intraventricular antibiotics for treating meningitis or ventriculitis between January 2018 and February 2020 at China Medical University Hospital. All identified patients were categorized into aminoglycoside or last-line antibiotic (i.e., colistin and tigecycline) group and compared on factors associated with treatment choices, infection cure rates, and side effects.
Results: Of 9 identified patients, 5 received aminoglycosides, and 4 received lastline antibiotic (with resistant pathogens). All patients in the aminoglycoside group were older than 45 years, while only 1 patient in the other group was (p = 0.048). There were no statistically significant differences in the cure rates or neuro-, renal-, and liver adverse drug reactions, and the changes of infection symptoms after treatment between the two groups (all p > 0.05).
Conclusions: No differences in cure rates, infection symptoms, or adverse drug reactions of intraventricular antibiotics were observed between patients receiving aminoglycoside or last-line intraventricular antibiotics. While patients receiving lastline antibiotics were younger, we presumed it might be associated with their infected resistant pathogens and encounter of severe infections.

Summited for publication: 2020.7.10; Accepted for publication: 2020.12.15