Intraventricular Tigecycline as a Last Resort Therapy in a Patient with Difficult-to-Treat Healthcare-Associated Acineto
- PDF / 560,139 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 65 Downloads / 196 Views
MEDICINE
Intraventricular Tigecycline as a Last Resort Therapy in a Patient with Difficult-to-Treat Healthcare-Associated Acinetobacter baumannii Ventriculitis: a Case Report Mohammad Abdallah 1 & Hamzeh Alsaleh 2 & Abdallah Baradwan 3 & Reem Alfawares 4 & Abdulaziz Alobaid 1 & Akram Rasheed 5 & Ibrahim Soliman 6 Accepted: 21 July 2020 / Published online: 9 August 2020 # Springer Nature Switzerland AG 2020
Abstract Healthcare-associated ventriculitis and meningitis is a common complication in patients who suffer from head trauma or have undergone a neurosurgery. Healthcare-associated ventriculitis and meningitis is associated with significant morbidity and mortality. Complications of healthcare-associated ventriculitis and meningitis include persistent vegetative state, moderate and severe disability, and death. Acinetobacter baumannii is the causative pathogen in 3.6–11.2% of cases of healthcare-associated ventriculitis and meningitis. Cases of difficult-to-treat healthcare-associated A. baumannii ventriculitis and meningitis are being reported more frequently. However, in most of these cases, a combination of intravenous (IV) and intraventricular (IVT)/intrathecal colistin achieves good therapeutic outcome. This report describes a clinical case of difficult-to-treat healthcare-associated A. baumannii ventriculitis. The A. baumannii strain was sensitive to colistin and trimethoprim-sulfamethoxazole, intermediate to tigecycline, and resistant to other antibiotics. While colistin was the drug of choice in our case, the patient developed anaphylactoid reaction during the IV administration of the loading dose of colistin, which mandated us to discontinue colistin and complicated the treatment of our patient. The patient did not respond to a combination of IV antibiotics that included meropenem, trimethoprim-sulfamethoxazole, and tigecycline. However, when IVT tigecycline was added as a last-resort therapeutic option, the patient’s ventriculitis dramatically improved, and the patient was discharged from the hospital. Physicians who treat patients with healthcare-associated A. baumannii ventriculitis might resort to IVT tigecycline when they run out of therapeutic options. Keywords Tigecycline . Intraventricular . Ventriculitis . Acinetobacter baumannii . Anaphylactoid reaction
Introduction This article is part of the Topical Collection on Medicine * Mohammad Abdallah [email protected] 1
Pharmaceutical Care Services, King Saud Medical City, Riyadh, Saudi Arabia
2
Pharmacy Department, Hamad Medical Corporation, Doha, Qatar
3
The Division of Infectious Diseases, King Saud Medical City, Riyadh, Saudi Arabia
4
Doha, Qatar
5
Department of Nursing Education and Development, King Saud Medical City, Riyadh, Saudi Arabia
6
Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia
Healthcare-associated ventriculitis and meningitis is a common complication in patients who suffer from head trauma or have undergone a neurosurgery. Healthcare-associated ventriculitis and meningitis is associated with sig
Data Loading...
