Klebsiella Meningitis Treated With Intrathecal Amikacin

Amikacin and colistin for treatment of Acinetobacter baumannii meningitis

“…Block successfully used IT amikacin 20 mg daily for 10 days along with intravenous carbenicillin and amikacin for K. pneumoniae meningitis. 12 CSF concentrations of greater than 20 mg/mL were achieved which far exceeded the MIC for the infecting organism. Gilbert treated six patients with IT amikacin 20-40 mg daily for meningitis associated with CSF leaks.…”

“…9 In limited case reports radicular pain, meningeal irritation, seizures and ototoxicity have been reported as potential adverse reactions to IT amikacin. 8,9,11,12 The maximal tolerable dose of IT amikacin is not known, but some patients have received up to 40 mg/d without apparent toxicity. 8 In the case presented we used an initial dose of 5 mg/d which was later increased to 10 mg/d.…”

“…7 Intrathecal amikacin in conjunction with systemic therapy has been used in patients with meningitis due to a variety of organisms. [8][9][10][11][12] In this report we describe the use of intrathecal amikacin in conjunction with intravenous amikacin and colistin for treatment of meningitis refractory to conventional therapy. A 52-year-old man developed meningitis due to A. baumannii on hospital day (HD) #28, 9 days after placement of a ventriculostomy catheter for management of subarachnoid hemorrhage.…”

Management of Aminoglycosides in the Intensive Care Unit

“…Other publications have alsoreported the use of intrathecal amikacin in the treatment of serious gram-negative meningitis. [127][128][129][130][131] Nationally, as our hospital pathogens become more resistant, the use of aminoglycosides may become more important in the treatment of bacterial meningitis.…”