Successful treatment of a brain infection requires aspiration of the pus or excision of the abscess, followed by long-term (usually 4−8 weeks) parenteral antibiotic treatment. Local antibiotic delivery using biodegradable drug-impregnated carriers is effective in treating postoperative infections, thereby reducing the toxicity associated with parenteral antibiotic treatment and the expense involved with long-term hospitalization. We have developed vancomycin-loaded, biodegradable poly[lactic-co-glycol acid] nanofibrous membranes for the sustainable delivery of vancomycin to the brain tissue of rats by using the electrospinning technique. A high-performance liquid chromatography assay was employed to characterize the in vitro and in vivo release behaviors of pharmaceuticals from the membranes. The experimental results suggested that the biodegradable nanofibers can release high concentrations of vancomycin for more than 8 weeks in the cerebral cavity of rats. Furthermore, the membranes can cover the wall of the cavity after the removal of abscess more completely and achieve better drug delivery without inducing adverse mass effects in the brain. Histological examination also showed no inflammation reaction of the brain tissues. By adopting the biodegradable, nanofibrous drug-eluting membranes, we will be able to achieve long-term deliveries of various antibiotics in the cerebral cavity to enhance the therapeutic efficacy of cerebral infections. KEYWORDS: Brain abscess, cerebral infection, biodegradable, poly[lactic-co-glycol acid], nanofibers, vancomycin Central nervous system (CNS) infection most commonly presents itself as meningitis, epidural abscess, subdural empyema, and/or brain abscess. 1 Brain abscess (or cerebral abscess) is an abscess caused by inflammation and collection of infected material, coming from local (ear infection, dental abscess, infection of paranasal sinuses, infection of the mastoid air cells of the temporal bone, epidural abscess) or remote (lung, heart, kidney, etc.) infectious sources, within the brain tissue.2,3 The infection may also be introduced through a skull fracture following head trauma or surgical procedures. Multiple factors have contributed to the increasing number of diagnosed CNS infections, including prolonged lifespan, increased incidence of solid-organ transplantation, and improved diagnostic imaging modalities.2 The incidence of brain abscesses is ∼8% in developing countries, whereas in developed countries the incidence is 1−2%.2,3 The incidence of postoperative CNS infection (PCNSI) is much higher than the incidence of brain abscess. Previous studies have reported the incidence of PCNSI after neurosurgical procedures to be 5−7% and as high as 10% when antibiotic prophylaxis is not administered.1 Successful treatment of a brain abscess requires a high index of suspicion for the infection, which can have subtle presentations, and frequently requires a combination of drainage and antimicrobial therapy. The recommended duration of parenteral antibiotic therapy...

Adopting the electrospinning technique will help in manufacturing biodegradable, nanofibrous membranes for the long-term deliveries of various anticancer drugs in the cerebral cavity, which will further enhance the therapeutic efficacy of GBM treatment.

The results of this study suggest that the lidocaine-loaded nanofibers can provide an easy, practical and safe means of achieving effective postlaminectomy analgesia.