Intrathecal Tigecycline in the Treatment of Hospital-Acquired Meningitis: A Review of Four Cases
Makaleler > Tam Makale · 2024
Yazarlar: Gamze Sanlidag Isbilen, Deniz Akyol, Taskin Yurtseven, Erkin Ozgiray, Mehmet Sedat Cagli, Sohret Aydemir, Bilgin Arda, Oğuz Reşat SİPAHİ
SURGICAL INFECTIONS, SCI İndekslerine Giren Dergi, Uluslararası, Wos, 2024, cilt 25, ss 627-631
DOI: 10.1089/sur.2024.063
Özet
Objectives: Carbapenem-resistant A. baumannii is a common cause of nosocomial meningitis, and it presents a challenge in terms of treatment because of limited therapeutic options. Intravenous tigecycline has been considered a potential salvage therapy against multi-drug-resistant Acinetobacter baumannii. However, its effectiveness is limited by its poor ability to cross the blood-brain barrier. As an alternative treatment option, intrathecal tigecycline has shown promise with its minimal side effects and high concentration in cerebrospinal fluid.Methods: In this report, we present a series of four cases infected with multi-drug-resistant A. baumannii following neurosurgery and treated with intrathecal tigecycline, including antimicrobial therapy.Results: The rate of successful microbiological response was 2 out of 3 cases (66%) in whom microbiological response could be tested anytime during the intrathecal therapy, whereas the 30-day survival rate after treatment completion was 1/4 (25%).Conclusion: Although intrathecal tigecycline treatment has shown relative efficacy in achieving microbiological response, its impact on overall survival is still uncertain. Further studies involving larger groups of patients are necessary to evaluate the outcomes of intrathecal tigecycline therapy.