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How to treat recidivant post traumatic frontal epidural empyema caused by Pseudomonas aeruginosa, resistant to antibiotics. Any experience with constant irrigation with povidone?

I'd be very careful with irrigation in general as the outflow catheter easily obstructs from debris and you could really cause high intracranial pressure. You must be sure that you get out at least the same volume you have got in.
Povidone has been shown to cause blindness after intrathoracic instillation, content.nejm.org/cgi/content/full/357/12/1264 so that shouldn't be an option either.
Just open drainage and no complete closure of the wound is may be the first option...

thanks

Empiema should be drained widelly in nasal cavity. Use Betadine and other antiseptics for local irrigation. Do not be afraid pollution from nasal mucosa. Do not touch dura!!!

Because of communication between ethmoid sinus and epidural space we at first had tension pneumocephalus and epidural empyema.