Document Detail

Intraventricular and intrathecal colistin as the last therapeutic resort for the treatment of multidrug-resistant and extensively drug-resistant Acinetobacter baumannii ventriculitis and meningitis: a literature review.
MedLine Citation:
PMID:  23507414     Owner:  NLM     Status:  MEDLINE    
Acinetobacter baumannii ventriculitis/meningitis due to the emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains has become a clinical entity of considerable importance in recent years. A review of the available literature regarding intraventricular (IVT) or intrathecal (ITH) administration of colistin in MDR and XDR A. baumannii ventriculitis/meningitis was conducted and a total of 83 episodes in 81 patients were identified (71 cases in adults and 10 in children and neonates). Colistin was administered via the IVT and ITH route in 52 and 22 cases, respectively, whilst in 7 cases the exact route was not identified. The median dose of local colistin was 125000 IU (10mg) with a range of 20000 IU (1.6 mg) to 500000 IU (40 mg) in adults, whilst a dose of 2000 IU/kg (0.16 mg/kg) up to 125000 IU (10mg) was used in the paediatric population. The median duration of treatment of IVT/ITH polymyxin E was 18.5 days, whilst the median time to achieve sterilisation of cerebrospinal fluid was 4 days. The rate of successful outcome was 89%, and toxicity related to treatment mainly manifested as reversible chemical ventriculitis/meningitis was reported in nine cases (11%). Nowadays, IVT and ITH colistin represents the last resort treatment of MDR and XDR A. baumannii ventriculitis/meningitis, offering a unique, rather safe and successful mode of therapy.
Ilias Karaiskos; Lambrini Galani; Fotini Baziaka; Helen Giamarellou
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Publication Detail:
Type:  Journal Article; Review     Date:  2013-03-16
Journal Detail:
Title:  International journal of antimicrobial agents     Volume:  41     ISSN:  1872-7913     ISO Abbreviation:  Int. J. Antimicrob. Agents     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-14     Completed Date:  2013-10-23     Revised Date:  2014-02-06    
Medline Journal Info:
Nlm Unique ID:  9111860     Medline TA:  Int J Antimicrob Agents     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  499-508     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
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MeSH Terms
Acinetobacter Infections / drug therapy*,  microbiology
Acinetobacter baumannii / drug effects*,  isolation & purification
Anti-Bacterial Agents / administration & dosage*
Cerebral Ventriculitis / drug therapy*,  microbiology
Cerebrospinal Fluid / microbiology
Colistin / administration & dosage*
Drug Resistance, Multiple, Bacterial*
Injections, Intraventricular
Injections, Spinal
Meningitis, Bacterial / drug therapy*,  microbiology
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Anti-Bacterial Agents; Z67X93HJG1/Colistin
Comment In:
Int J Antimicrob Agents. 2014 Jan;43(1):93-4   [PMID:  24239406 ]

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