Successful treatment of extensively drug-resistant Acinetobacter baumannii ventriculitis and meningitis with intraventricular colistin after application of a loading dose: a case series

Int J Antimicrob Agents. 2013 May;41(5):480-3. doi: 10.1016/j.ijantimicag.2013.02.010. Epub 2013 Apr 6.

Abstract

Treatment results of six post-neurosurgical ventriculitis and meningitis cases caused by extensively drug-resistant Acinetobacter baumannii after application of an intraventricular loading dose of 500000 IU (40 mg) of colistin followed by a dose of 125000-250000 IU (10-20 mg) every 24-48 h plus parenteral colistin are reported. Simultaneous bacteraemia with an identical Acinetobacter strain was observed in three patients. The mean duration of treatment was 17.2 days (range 15-21 days) and the median time of sterilisation of cerebrospinal fluid was 2.5 days (range 1-5 days). All patients were cured, however one patient presented with chemical meningitis and one with chemical ventriculitis, conditions that clinically and biochemically resemble bacterial meningitis.

Publication types

  • Case Reports

MeSH terms

  • Acinetobacter Infections / drug therapy*
  • Acinetobacter baumannii / drug effects*
  • Acinetobacter baumannii / isolation & purification
  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Cerebral Ventriculitis / complications
  • Cerebral Ventriculitis / drug therapy*
  • Cerebrospinal Fluid / microbiology
  • Colistin / administration & dosage*
  • Drug Resistance, Multiple, Bacterial*
  • Female
  • Humans
  • Infusions, Intraventricular
  • Male
  • Meningitis / complications
  • Meningitis / drug therapy*
  • Middle Aged
  • Surgical Wound Infection / drug therapy
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Colistin