1. Infectious complications and treatment options in intrathecal baclofen delivery systems Themistoklis K, Boutos N, Themistokleous M, Kalyvas AV, Sakas DE Neurosurgery Department, Evaggelismos hospital, University of Athens, Athens, Greece

2. Patients and methods  275 patients, from 2001 to 2013  11 (4%) presented with infection  6F/5M ( f/m = 1.2 )  Median age was 49y ( ranging from 33 to 65 y)

3. Patients and methods n=6 n=1 n=4 N=6

4. mAS Number of patients with infection Patients and methods

5. Underlying PathologyNumber of patients with infection Cerebral Palsy5 Multiple Sclerosis3 Traumatic brain Injury3

6. Results Infectious agent  Staphylococcus aureus: 6  Staphylococcus epidermitis: 4  Pseudomonas aeruginosa: 1 Treatment options Superficial infections (n=6) IV antibiotics (n=4) IV antibiotics, surgical reposition of the pump (contralaterally) due to skin erosion (n=2) Deep infections (n=1) IV antibiotics, surgical reposition of the pump (contralaterally) CNS Infections (n=4) IV and intrathecal antibiotics (n=2) IV and intrathecal antibiotics, surgical removal of the pump and re-implantation after 6 months (n=2)

7. Treatment without removal: No interruption of therapy Lower cost Prevention of infections Conclusion

8. Thank you for your attention