Very high intraventricular chloramphenicol levels can be obtained if the standard systemic dose is supplemented with a small intraventricular dose. Chloramphenicol sodium succinate can be hydrolyzed to the microbiologically active chloramphenicol in the ventricular fluid. Daily injections are ordinarily adequate to maintain a high concentration of antibiotic. Initial dosage should vary with ventricular volume. The brain does not tolerate repeated needle puncture and the use of a ventriculostomy reservoir is recommended.