George Fotakopoulos1,2, Demosthenes Makris3, Maria Chatzi3, Eleni Tsimitrea3, Epaminondas Zakynthinos3, Kostas Fountas4. 1. Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110, Larissa, Thessaly, Greece. gfotakop@yahoo.gr. 2. , Vounargo, Pyrgou, Ilias, 27100, Greece. gfotakop@yahoo.gr. 3. Department of Head of Critical Care, University of Thessaly, University Hospital of Larissa, Biopolis, 41110, Larissa, Thessaly, Greece. 4. Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110, Larissa, Thessaly, Greece.
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.
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.
Authors: Brian T Tsuji; Jason M Pogue; Alexandre P Zavascki; Mical Paul; George L Daikos; Alan Forrest; Daniele R Giacobbe; Claudio Viscoli; Helen Giamarellou; Ilias Karaiskos; Donald Kaye; Johan W Mouton; Vincent H Tam; Visanu Thamlikitkul; Richard G Wunderink; Jian Li; Roger L Nation; Keith S Kaye Journal: Pharmacotherapy Date: 2019-01 Impact factor: 6.251