A retrospective study on the efficacy of neuro-endoscopic lavage compared to conventional antibiotic treatment in pyogenic ventriculitis.

Pyogenic ventriculitis (PV) is a severe and challenging infection with high morbidity, commonly associated with neurosurgical procedure. Conventional treatment involves prolonged antibiotic therapy and cerebrospinal fluid drainage but is associated with poor outcome. Neuro-endoscopic lavage (NEL) is a promising technique allowing direct reduction of bacterial load, which can potentially improve patient outcomes. This study aims to address the safety and efficacy of NEL. A retrospective cohort study was conducted on 22 patients with PV treated at West China Hospital from December 2019 to March 2024. Patients were divided into two groups: one receiving conventional therapy and the other undergoing NEL in addition to standard treatment. Primary and secondary outcomes, including clinical cure rate, mortality, and CSF sterilization, were analyzed. NEL significantly improved the clinical cure rate (83.33% vs. 40.00%, P = 0.0480). Although the 6-month mortality rate was not significantly different (P = 0.3233), NEL showed a trend toward faster recovery and a higher CSF sterilization rate. Neuro-endoscopic lavage significantly improves clinical outcomes in patients with pyogenic ventriculitis and represents a safe, preferred treatment option.