Colistin and tigecycline for management of external ventricular device-related ventriculitis due to multidrug-resistant Acinetobacter baumannii

Shrestha, Gentle Sunder; Tamang, Sushil; Paneru, Hem Raj; Shrestha, Pramesh Sunder; Keyal, Niraj Kumar; Acharya, Subhash Prasad; Marhatta, Moda Nath; Shilpakar, Sushil Krishna

doi:10.4103/0976-3147.176194

Cited by 11 publications

(13 citation statements)

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“…A systematic review of the evidence regarding clinical efficacy and safety of IVT or ITH colistin or polymyxin B was conducted . A total of 234 cases of gram‐negative health care–associated ventriculitis or meningitis treated with IVT or ITH colistin or polymyxin B were reported.…”

Section: Clinical Questions and Recommendationsmentioning

confidence: 99%

“…153 A systematic review of the evidence regarding clinical efficacy and safety of IVT or ITH colistin or polymyxin B was conducted. [159][160][161][162][163][164][165][166][167][168][169][170][171][172][173][174][175][176] A total of 234 cases of gram-negative health care-associated ventriculitis or meningitis treated with IVT or ITH colistin or polymyxin B were reported. Intraventricular or ITH colistin was administered in 87% of cases and polymyxin B in the remaining 13%.…”

Section: Should Intraventricular or Intrathecal Administration Ofmentioning

confidence: 99%

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International Consensus Guidelines for the Optimal Use of the Polymyxins: Endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti‐infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP)

et al. 2019

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The polymyxin antibiotics colistin (polymyxin E) and polymyxin B became available in the 1950s and thus did not undergo contemporary drug development procedures. Their clinical use has recently resurged, assuming an important role as salvage therapy for otherwise untreatable gram‐negative infections. Since their reintroduction into the clinic, significant confusion remains due to the existence of several different conventions used to describe doses of the polymyxins, differences in their formulations, outdated product information, and uncertainties about susceptibility testing that has led to lack of clarity on how to optimally utilize and dose colistin and polymyxin B. We report consensus therapeutic guidelines for agent selection and dosing of the polymyxin antibiotics for optimal use in adult patients, as endorsed by the American College of Clinical Pharmacy (ACCP), Infectious Diseases Society of America (IDSA), International Society of Anti‐Infective Pharmacology (ISAP), Society for Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP). The European Society for Clinical Microbiology and Infectious Diseases (ESCMID) endorses this document as a consensus statement. The overall conclusions in the document are endorsed by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). We established a diverse international expert panel to make therapeutic recommendations regarding the pharmacokinetic and pharmacodynamic properties of the drugs and pharmacokinetic targets, polymyxin agent selection, dosing, dosage adjustment and monitoring of colistin and polymyxin B, use of polymyxin‐based combination therapy, intrathecal therapy, inhalation therapy, toxicity, and prevention of renal failure. The treatment guidelines provide the first ever consensus recommendations for colistin and polymyxin B therapy that are intended to guide optimal clinical use.

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Section: Clinical Questions and Recommendationsmentioning

confidence: 99%

Section: Should Intraventricular or Intrathecal Administration Ofmentioning

confidence: 99%

International Consensus Guidelines for the Optimal Use of the Polymyxins: Endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti‐infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP)

et al. 2019

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“…Therefore, to limit the influence of this shortage, we considered combining IV and CVI with IVT tigecycline that may be a potential treatment alternative for our patient. CVI tigecycline in addition to IV and (or) IVT tigecycline was not used in previous studies, and yet, patients in previous studies were cured ( 6 – 11 ). We administered CVI tigecycline because our patients developed a local infection of the lesions in the bilateral ventricles, and a large amount of cellulose deposite was observed in the ventricles using a ventriculoscope.…”

Section: Discussionmentioning

confidence: 99%

“…The reviewed six articles which met the inclusion criteria, and a total of seven patients with meningitis/ventriculitis due to MDR A. baumannii , were included and treated with tigecycline ( 6 – 10 , 11 ). Moreover, we included one case of A. baumannii (AB) ventriculitis, with antibiograms for the isolates of AB only susceptible to tigecycline, which were treated with abscess clearance on a ventriculoscope combined with CVI and IVT tigecycline treatment.…”

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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“…Был проведен систематический обзор доказательных данных в отношении клинической эффективности и безопасности ИВТ или ИТК введения колистина [159][160][161][162][163][164][165][166][167][168][169][170][171][172][173][174][175][176]. В общей сложности было включено 234 случая нозокомиального грамотрицательного вентрикулита или менингита, в отношении которых применялось ИВТ или ИТК введение колистина или полимиксина В. Интравентрикулярный или ИТК колистин применялся в 87% случаев, в то время как полимиксин В -в оставшихся 13%.…”

Section: антимикробные препаратыunclassified

Review of the international consensus guidelines for the optimal use of the polymyxins

Елисеева

Azyzov

Зубарева

2019

CMAC

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Polymyxins are often the only agents that remain in vitro active against extensively resistant bacterial pathogens. However, the use of polymyxins is compromised by the number of unresolved issues, including the technical aspects of antimicrobial susceptibility testing, pharmacokinetic and pharmacodynamics parameters, optimal dosing regimens, and combined use with other antibiotics. All of the aspects of polymyxin use are discussed in detail in recently published «International consensus guidelines for the optimal use of the polymyxins», that was endorsed by the following professional societies: American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Antiinfective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP).

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Colistin and tigecycline for management of external ventricular device-related ventriculitis due to multidrug-resistant Acinetobacter baumannii

Cited by 11 publications

References 10 publications

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

Review of the international consensus guidelines for the optimal use of the polymyxins

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