IDSA Recommended Dosages of Antimicrobial Agents Administered by the Intraventricular Route

Amikacin - 5–50 mg

Amphotericin B - 0.01–0.5 mg in 2 mL of 5% dextrose inwater

Colistin - 10 mg

Daptomycin - 2–5 mg

Gentamicin - 1–8 mg

Polymyxin B - 5 mg

Quinupristin/dalfopristin - 2–5 mg

Tobramycin - 5–20 mg

Vancomycin - 5–20 mg

Dosage recommendations in adults based on ventricle size/volume as follows:

 • Slit ventricles: 5 mg vancomycin and 2 mg gentamicin

 • Normal size: 10 mg vancomycin and 3 mg gentamicin

 • Enlarged ventricles: 15–20 mg vancomycin and 4–5 mg gentamicin.

Recommendations for frequency of administration based on external ventricular drain output over 24 hours as follows:

 • <50 mL/24 hours: every third day

 • 50–100 mL/24 hours: every second day

 • 100–150 mL/24 hours: once daily

 • 150–200 mL/24 hours: increase the dosage by 5 mg of vancomycin and 1 mg of gentamicin and give once daily

 • 200–250 mL/24 hours: increase the dosage by 10 mg of vancomycin and 2 mg of gentamicin and give once daily.



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