Outcomes in meningitis/ventriculitis treated with intravenous or intraventricular plus intravenous colistin

Acta Neurochir (Wien). 2016 Mar;158(3):603-10; discussion 610. doi: 10.1007/s00701-016-2702-y. Epub 2016 Jan 23.

Abstract

Background: The aim of this work is to evaluate the outcome of patients treated with intrathecal colistin for meningitis/ventriculitis.

Methods: This retrospective case series study included patients presenting with nosocomial meningitis/ventriculitis following neurosurgical interventions and having intravenous (IVC group) or intravenous and intrathecal/intraventricular colistin (ITC group) treatment between 2006 and 2014.

Results: Thirty-four patients presented nosocomial meningitis/ventriculitis; 11 (32.5 %) were included in the IVC group and 23 (67.6 %) in the ITC group. The most frequent isolated bacteria were Acinetobacter baumannii. The mean dose was 170,000 (±400) IU and the duration of intraventricular treatment was 16.0 (±8.3) days. The duration of intravenous treatment was 16.0 (±8.3) days in the ITC group and 15.3 ± 7.6 days in IVC group. Hospital mortality was significantly lower in the ITC group compared with the IVC group (13 vs. 72.7 %, p = 0.001).

Conclusions: The combination of intravenous plus intraventricular (IV-IVT) colistin therapy may improve outcomes in patients attending with meningitis/ventriculitis due to multi-drug resistance infections.

Keywords: CNS infections; Intrathecal/intraventricular colistin treatment; Nosocomial meningitis/ventriculitis.

MeSH terms

  • Acinetobacter Infections / drug therapy*
  • Administration, Intravenous
  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / therapeutic use
  • Cerebral Ventriculitis / drug therapy*
  • Colistin / administration & dosage*
  • Colistin / therapeutic use
  • Female
  • Humans
  • Injections, Intraventricular
  • Male
  • Meningitis, Bacterial / drug therapy*
  • Middle Aged

Substances

  • Anti-Bacterial Agents
  • Colistin