Table 2.
Studies regarding (IV or CVI or IVT) administration of tigecycline in Acinetobacter baumannii meningitis/ventriculitis (II).
| Reference | (6) | (7) | (8) | (9) |
|---|---|---|---|---|
| Age | 75 | 22 | 50 | 42 |
| Sex | male | male | male | male |
| Underlying disease(s) | Frontal contusion, subdural hematoma | Giant pituitary adenoma, CSF leak | Cranial traumatic brain injury hydrocephalus | Ependymoma 4th ventricle, CSF leak |
| Foreign body | EVD | Fibrin glue, dural substitutes | No | EVD |
| Days from admission to diagnosis | 4 | 18a | 31 | 15 |
| Antimicrobial susceptibilities | Susceptible to TGC, CST; XDR | Susceptible to TGC, (MIC = 2 μg/mL); MDR | Susceptible to TGC; XDR | Susceptible to TGC(MIC = 0.5 μg/mL) CST(MIC < 0.5 μg/mL); MDR |
| Current antimicrobial regimens | TGC and CST | TGC, CST, meropenem and vancomycin | Cefoperazone-sulbactam, TGC | TGC, CST, and amikacin |
| IV/CVI/IVT tigecycline | IV,50 mg/q12h | IV, 100 mg/q12 h IVT, 2 mg/(q24h-q12h) | IV, 100 mg/q12 h IVT, (3–4)mg/q12h | IV,50 mg/q12h |
| Co-administered antibiotics | CST IV, 2 million IU/q8h IVT, 0.2 million IU/q24h | CST IVT, 120,000/q12h Meropenem IV, 2 g/q8h Vancomycin IV, 1 g/q12h | Cefoperazone-sulbactam IV, 3g/q12h | CST IV, 2 million IU/q6h ITH, 150,000 IU/q24h |
| Days to CSF sterilization | 7 | 75 | 14 | 20 |
| Toxicity | Renal dysfunction (CST) | Chemical ventriculitis, Myelitis(CST) | None | None |
| Infection outcome | Cured | Cured | Cured | Cured |
| Survival | NRb | Yes | Yes | Yes |
CSF, cerebrospinal fluid; MIC, minimum inhibitory concentration; EVD, external ventricular drain; MDR, multidrug resistant; XDR, extensively drug-resistant; TGC, tigecycline; CST, colistin; q6h, every 6 h; q8h, every 8 h; q12h, every 12 h; q24h, every 24 h; IV, intravenous; CVI, continuous ventricular irrigation; IVT, intraventricular; NR, not reported;
On day 18 after endoscopic transsphenoidal surgery for the removal of a giant pituitary adenoma.
Due to progressive worsening of renal function and GCS, the family members of the patient decided to withdraw the support due to anticipated poor neurological outcome despite microbiological cure of ventriculitis. The patient most likely died after discharge.