A Review of Safety and Effectiveness of Intravenous and Intraventricular Tigecycline in Healthcare-Associated Acinetobacter baumannii Meningitis and Ventriculitis

Intraventricular Tigecycline as a Last Resort Therapy in a Patient with Difficult-to-Treat Healthcare-Associated Acinetobacter baumannii Ventriculitis: a Case Report

“…Tigecycline was approved in 2005 by the FDA for the treatment of community-acquired pneumonia, complicated skin and skin structure infections, and complicated intra-abdominal infections. Because of its excellent effectiveness against MDR Gram-negative and Gram-positive bacteria, its safety profile, its preservative-free formulation, its synergistic effect with many antibiotics, and limited penetration to the central nervous system, IVT tigecycline is considered an attractive and promising last-resort therapeutic option for treating patients with healthcare-associated bacterial ventriculitis and meningitis [ 4 ].…”

“…We used trimethoprim-sulfamethoxazole 20 mg per kg since the CSF culture reports showed MDR A. baumannii that was sensitive to it, and we ran out of options, especially after the anaphylactoid reaction caused by colistin. IVT tigecycline was recently used by some clinicians as a last resort to treat healthcare-associated A. baumannii ventriculitis and meningitis [ 4 ]. Our patient did not respond to a combination therapy that included meropenem, trimethoprim-sulfamethoxazole, and high-dose tigecycline.…”

“…Cases of difficult-to-treat healthcare-associated A. baumannii ventriculitis and meningitis are being reported more frequently [ 4 ]. However, in most of these cases, a combination of IV and IVT/intrathecal colistin achieves good therapeutic outcome [ 5 , 6 ].…”