Intraventricular administration of tigecycline for the treatment of multidrug-resistant bacterial meningitis after craniotomy: a case report

Wu, Yun; Chen, Kai; Zhao, Jingwei; Wang, Qiang; Zhou, Jianxin

doi:10.1080/1120009x.2017.1338846

Cited by 28 publications

(24 citation statements)

References 13 publications

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“…The patient received 2 weeks of IVT tigecycline and no adverse effects were observed. Wu et al 12 described a 67-year-old man who developed MDR K. pneumoniae meningitis after having hematoma removal and EVD placement due to cerebral hemorrhage. Based on the patient's response, the authors administered the following doses of tigecycline: 50 mg IV/1 mg intra-cerebroventricular (ICV) every 12 hours, 45 mg IV/5 mg ICV every 12 hours, and 40 mg IV/10 mg ICV every 12 hours, respectively, in combination with cotrimoxazole (sulfamethoxazole 0.4 g, trimethoprim 0.08 g per pill, 2 pills per day).…”

Section: Discussionmentioning

confidence: 99%

Intraventricular tigecycline for the treatment of shunt infection: a case in pediatrics

Curebal¹,

Dalgıç

Bayraktar

2019

Journal of Neurosurgery: Pediatrics

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Ventriculoperitoneal (VP) shunt infections are seen in 3%–17% of patients with VP shunts. These infections may cause severe morbidity and mortality. Staphylococci are the most common cause of CSF shunt-associated infections, although gram-negative bacteria (especially multidrug-resistant [MDR] and extensive drug–resistant [XDR] bacteria) also play an important role. Due to increased antibiotic resistance, sometimes off-label usage of antibiotics is considered. Tigecycline is one of these antibiotics. It should not be used unless there are no other antibiotic treatment options available, especially in children. It belongs to the glycylcycline class of antibiotic agents and inhibits protein translation in bacteria by binding to the 30S ribosomal subunit. The authors describe the case of a patient who had an XDR Klebsiella pneumoniae–positive VP shunt infection. After removal of his VP shunt, an external ventricular drain was inserted, and the patient was treated with a combination of intravenous (1.2 mg/kg/day) and intraventricular (4 mg/day) tigecycline in addition to his meropenem (120 mg/kg/day) treatment. On the 7th day of the combined therapy, his CSF culture was sterile. Because tigecycline distribution into the tissues is not sufficient with intravenous administration, combining it with intraventricular infusion can provide new treatment methods. However, further studies are needed for its use as a treatment method in children.

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Section: Discussionmentioning

confidence: 99%

Intraventricular tigecycline for the treatment of shunt infection: a case in pediatrics

Curebal¹,

Dalgıç

Bayraktar

2019

Journal of Neurosurgery: Pediatrics

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“…Lengerke et al [25] reported higher tigecycline level in inflamed CSF vs non-inflamed CSF and suggested that higher tigecycline levels may cause higher CSF levels. Interestingly, in recently published three case reports [26][27][28] Lauretti et al [26] and Fang et al [28] reported both clinical and microbiological success. In our series none of the cases received intrathecal or intravenous high dose tigecycline probably due to the fact that all strains were susceptible to tigecycline and/or reimbursement problems.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…In the presented study all strains were susceptible to tigecycline. Data regarding tigecycline in meningitis or A. baumannii meningitis is rare[6,7,16,[23][24][25][26][27][28]. To our knowledge, there are a few reports in which tigecycline is used to treat A. baumannii meningitis.…”

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confidence: 99%

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Tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii meningitis: Results of the Ege study

Sıpahi

Mermer

Demırdal

et al. 2018

Clinical Neurology and Neurosurgery

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“…Tigecycline is an antibiotic with an excellent activity against a broad spectrum of MDR pathogens, including Acinetobacter baumannii and Klebsiella pneumoniae , with a favorable toxicity profile. The use of tigecycline received approval from the Food and Drug Administration in the USA in 2005, and currently, this drug can only be administered intravenously ( 3 ). The effectiveness of tigecycline for treating intracranial A. baumannii infections is still controversial because of its low CSF penetration level ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Multidrug Resistant Brain Abscess Due to Acinetobacter baumannii Ventriculitis Cleared by Intraventricular and Intravenous Tigecycline Therapy: A Case Report and Review of Literature

et al. 2018

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Objective: Ventricular infection from multidrug-resistant (MDR) Acinetobacter baumannii (A. baumannii) is one of the most severe complications of craniotomy. However, the availability of effective therapeutic options for these infections is limited. Thus, this report aims to describe the efficacy of abscess clearance by intraventricular and intravenous tigecycline therapy in managing patients with multidrug-resistant A. baumannii ventriculitis after neurosurgery. Moreover, the current literature on the use of tigecycline therapy for these life-threatening infections is reviewed and summarized, and a treatment regimen based on the available data is proposed.Methods: A patient with multidrug-resistant A. baumannii ventriculitis was admitted in our hospital and was provided with a detailed therapeutic schedule. Tigecycline treatments for multidrug-resistant A. baumannii ventriculitis that were reported in the literature were also reviewed and summarized.Results: The patient in our hospital underwent abscess clearance on a ventriculoscope and was subsequently subjected to multi-route tigecycline therapy 14 days after the start of the continuous ventricular irrigation (CVI) tigecycline and 3 days after the intraventricular (IVT) tigecycline. The signs of ventriculitis disappeared, and the Acinetobacter cerebrospinal fluid (CSF) load steadily decreased until CSF sterilization. Literature review identified seven cases of ventricular infection from multidrug-resistant A. baumannii treated with tigecycline. In the eight cases, all patients were male adults (>18 years), with a mean age of 46.1 (range: 22–75) years. Meningitis/ventriculitis was secondary to neurosurgery procedures for the management of various central nervous system diseases in all cases. A good clinical outcome was achieved in all eight patients with multidrug-resistant A. baumannii meningitis/ventriculitis treated with CVI and/or IVT tigecycline, and any relevant complications were not observed.Conclusions: CVI and IVT tigecycline and IVT colistin could be considered as the first-line therapy in patients with ventricular infections from MDR/extreme drug-resistant A. baumannii. However, more studies should be conducted to confirm our observation.

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Intraventricular administration of tigecycline for the treatment of multidrug-resistant bacterial meningitis after craniotomy: a case report

Cited by 28 publications

References 13 publications

Intraventricular tigecycline for the treatment of shunt infection: a case in pediatrics

Intraventricular tigecycline for the treatment of shunt infection: a case in pediatrics

Tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii meningitis: Results of the Ege study

Multidrug Resistant Brain Abscess Due to Acinetobacter baumannii Ventriculitis Cleared by Intraventricular and Intravenous Tigecycline Therapy: A Case Report and Review of Literature

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