This clinical trial aims to compare two methods of administering polymyxin B for treating severe brain infections caused by carbapenem-resistant Gram-negative bacteria (CRGNB). The two methods are: 1) delivering polymyxin B directly into the brain (intracranial administration) and 2) combining this with an intravenous (IV) infusion. The goal is to determine which approach is more effective in clearing the infection, improving patient outcomes, and influencing the concentration of polymyxin B in the cerebrospinal fluid (CSF). Participants in this study will be monitored for both effectiveness and safety, with a focus on CSF polymyxin B levels, to find the best treatment strategy for these challenging infections.
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30-Day All-Cause Mortality Rate
Timeframe: 30 days from the start of treatment
CSF Bacterial Clearance
Timeframe: Baseline, 1 week, 2 weeks, and 30 days after initiation of treatment.
Clinical Cure Rate
Timeframe: At the end of treatment (defined as the last day of the planned treatment regimen) and 30 days post-treatment