Intrathecal or intraventricular antimicrobial therapy for post-neurosurgical intracranial infection due to multidrug-resistant and extensively drug-resistant Gram-negative bacteria: A systematic review and meta-analysis

•ITH/IVT therapy for post-neurosurgical intracranial infection due to MDR/XDR Gram-negative bacteria was investigated.•The odds ratio (OR) for death (IV+ITH/IVT vs. IV) ranged from 0.02–0.93.•The overall pooled OR was 0.15 (95% CI 0.08–0.28) and risk of mortality was significantly different between the two groups.•Microbiological clearance was significantly different between the two groups, with a pooled OR of 0.02 (95% CI 0.01–0.10).•Addition of ITH/IVT antimicrobial therapy is associated with lower mortality risk and higher microbiological clearance.