Table 3. Characteristics of adults previously reported with CNS infection treated with intraventricular tygecycline.
| Characteristic | Patient 1 (Lauretti L, et al) | Patient 2 (Fang JQ, et al) | Patient 3 (Long W, et al) | Patient 54 (Tsolaki V, et al) | Patient 5 (Tsolaki V, et al) | Patient 6 (Tsolaki V, et al) | Patient 7 (Wu Y, et al) |
|---|---|---|---|---|---|---|---|
| Age, y/sex | 22y/M | 50y/M | 55y/M | 55y/F | 50y/M | 48y/M | 67y/M |
| Country | Italy | China | India | Greece | Greece | Greece | China |
| Underlying disease (s) | A giant pituitary adenoma, post-resection CSF leak | Craniocerebral injury | Intracerebellar hemorrhage, CSF leak, hydrocephalus, EVD | Aneurysmal subarachnoid hemorrhage | Intraventricular mass resection, cerebral edema, EVD | Cerebellum spontaneous hemorrage, EVD | Cerebral haemorrhage, EVD |
| Primary infection | Post-neurosurgical meningitis | Post-neurosurgical meningitis | Post-neurosurgical ventriculitis | Post-neurosurgical VM | Post-neurosurgical VM | Post-neurosurgical VM | Post-neurosurgical meningitis |
| Organism (s) | XDRAB | MDRAB | MDRAB | MDRAB | MDRKP | MDRKP | |
| Tigecycline MIC (mg/L) | 2 μg/ml | 2 | 16 µg/mL | 2 μg/ml | 1 μg/ml | NR | |
| Tigecycline concentrations (mg/L) | NR | NR | NR | NR | NR | NR | The trough concentrations of tigecycline in CSF for the three different dosages of tigecycline IV - ICV combined administration were 0.313, 1.290 and 2.886 mg/L for 40 mg IV/10 mg ICV, 45 mg IV/5 mg ICV and 50 mg, IV/1 mg ICV tigecycline, respectively |
| Side effects | Chemical ventriculitis, Myelitis (CST) | None | None | None | None | None | None |
| TGC, IV/CVI/IVT | IV, 100 mg/q12h IVT, 2 mg/(q24h - q12h) | IV, 100 mg/q12h IVT, (3 - 4) mg/q12h | IV, 100 mg/q12h, CVI, 10 mg/q12h, IVT, 2 mg/q12h | IV, 100 mg q12, IVT, 4 mg/dl | IV, NR | IV, NR | IV, 45 mg q12h, /40mg q12h |
| IVT | IVT | IVT, 1 mg q12h, 5mg q12h, 10 mg q12h | |||||
| LOT (Days) | IVT, 45 days; 1 month from the restart of the IVT | IV, 14 days; ITV, 14 days | IV, 14 days, CVI, 14 days, IVT, 3 days | IV TGC, 14 days | IV TGC, 15 days | IV TGC, 9 days | NR |
| IVT TGC, 15 days | IVT TGC, 15 days | IVT TGC, 9 days | |||||
| IVT CST, 22 days | IVT CST, 30 days | IVT CST, 11 days | |||||
| Co-administered antibiotics | CST IVT, 120,000/q12h | Cefoperazone-sulbactam IV, 3 g/q12h | Cefoperazone-sulbactam IV, (2 g/q8h) | IVT CST 250 x 103 IU qd | CST 250 x 103 IU qd | CST 125 x 103 IU qd | TMP/SMX 480 mg q12h per os |
| Meropenem IV, 2 g/q8h | |||||||
| Vancomycin IV, 1 g/q12h | |||||||
| Outcome | Improved | Improved | Improved | Improved | Improved | Improved | Improved |
| Days to CSF sterilization | 75 | 14 | 12 | 4 days of IVT COL - TGC | 5 days of IVT | 3 days of IVT | 42nd day with IVT TGC 10 mg (gradually escalating dose) |
CNS, central nervous system; M, male; F, female; CSF, cerebrospinal fluid; EVD, external ventricular device; VM, ventriculitis and meningitis; XDRAB, extensive drug resistant Acinetobacter baumannii; MDRAB, multidrug-resistant Acinetobacter baumannii; MDRKP, multi-drug resistant Klebsiella pneumoniae; NR, not reported; IV, intravenous; IVT, intra-ventricular therapy; CVI, continuous ventricular irrigation; LOT, length of treatment; TGC, tygecicline; TMP/SMX, trimethoprim-sulfamethoxazole; COL, colimycin.