Antibiotherapy in neurosurgical patients as a blood-brain barrier cheater – is it worth it?

The blood-brain barrier (BBB) is a mandatory mechanism in the vascular dynamic of the central nervous system (CNS). It employs multiple processes to maintain homeostasis. A systematic literature review was conducted, encompassing 65 sources from different databases, that involved studies solely on humans. Potential routes, and barriers to pharmacotherapy were identified and described. In conclusion, antibiotherapy continues to be a relevant topic due to the diverse and sometimes conflicting pharmacodynamic properties exhibited by different antibiotic classes under varying pathological conditions.