Role of Subdural Antibiotic Therapy in the Management of Pediatric Bilateral Subdural Empyema

Introduction

Use of intrathecal antibiotic therapy in the management of intracranial infections is a practice often required, usually administered through lumbar punctures or ventricular drains placement. Antibiotic administration through subdural drains is not a common practice in subdural empyemas treatment and limited evidence to date exists in the literature. To our best knowledge, this practice has not been previously reported in pediatric patient.

Case report

We present the case of a pediatric patient with bilateral subdural hematomas with posterior superinfection, who was treated by surgical evacuation and direct administration of Gentamicin through subdural drains. Resolution of the infection was achieved after institution of subdural antibiotic therapy.

Conclusion

Despite limited experience and evidence regarding administration of subdural antibiotic therapy as part of subdural empyema treatment, this practice may be beneficial in properly selected patients in addition to surgical management and intravenous antibiotic therapy.