Outcomes of adjunctive therapy with intrathecal or intraventricular administration of colistin for post-neurosurgical meningitis and ventriculitis due to carbapenem-resistant acinetobacter baumannii

Sarunyou Chusri, Ittichai Sakarunchai, Narongdet Kositpantawong, Siripen Panthuwong, Wichai Santimaleeworagun, Sutthiporn Pattharachayakul, Kamonnut Singkhamanan, Yohei Doi

Research output: Contribution to journalArticle

Abstract

The efficacy and safety of intrathecal (ITH) or intraventricular (IVT) colistin in addition to intravenous (IV) colistin for meningitis and ventriculitis due to carbapenem-resistant Acinetobacter baumannii (CRAB) is unclear. In this retrospective observational study of 40 patients with post-neurosurgical meningitis and ventriculitis due to CRAB, 33 patients without concomitant infection received appropriate dosage regimens of IV colistin. Of the 33 patients, 17 received additional ITH/IVT colistin and 16 received only IV colistin. The 14-day, 30-day and in-hospital mortality rates were nominally lower for patients who received ITH/IVT colistin adjunctive therapy versus patients who received only IV colistin (24% vs. 38%, 29% vs. 56% and 29% vs. 56%, respectively). The costs of treatment were significantly lower, the lengths of hospital and intensive care unit (ICU) stay were significantly shorter, and the number of ventilator days was significantly less among patients who received ITH/IVT colistin compared with patients who did not receive ITH/IVT colistin. The initial Acute Physiology and Chronic Health Evaluation (APACHE) II and Glasgow Coma Scale (GCS) scores were associated with 30-day mortality with odds ratios (95% confidence intervals) of 1.21 (1.08–1.46) and 0.77 (0.44–0.85), respectively. Chemical meningitis from ITH/IVT colistin was mild and resolved spontaneously. Treatment of post-neurosurgical CRAB meningitis and ventriculitis with ITH/IVT colistin as an adjunct to IV colistin was associated with shorter lengths of hospital and ICU stay and a trend to lower mortality, especially among severely ill patients.

Original languageEnglish
Pages (from-to)646-650
Number of pages5
JournalInternational Journal of Antimicrobial Agents
Volume51
Issue number4
DOIs
Publication statusPublished - 01-04-2018

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Colistin
Acinetobacter baumannii
Carbapenems
Meningitis
Therapeutics
Intensive Care Units
Mortality
Glasgow Coma Scale
APACHE
Mechanical Ventilators
Hospital Mortality
Health Care Costs
Observational Studies

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Chusri, Sarunyou ; Sakarunchai, Ittichai ; Kositpantawong, Narongdet ; Panthuwong, Siripen ; Santimaleeworagun, Wichai ; Pattharachayakul, Sutthiporn ; Singkhamanan, Kamonnut ; Doi, Yohei. / Outcomes of adjunctive therapy with intrathecal or intraventricular administration of colistin for post-neurosurgical meningitis and ventriculitis due to carbapenem-resistant acinetobacter baumannii. In: International Journal of Antimicrobial Agents. 2018 ; Vol. 51, No. 4. pp. 646-650.
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Outcomes of adjunctive therapy with intrathecal or intraventricular administration of colistin for post-neurosurgical meningitis and ventriculitis due to carbapenem-resistant acinetobacter baumannii. / Chusri, Sarunyou; Sakarunchai, Ittichai; Kositpantawong, Narongdet; Panthuwong, Siripen; Santimaleeworagun, Wichai; Pattharachayakul, Sutthiporn; Singkhamanan, Kamonnut; Doi, Yohei.

In: International Journal of Antimicrobial Agents, Vol. 51, No. 4, 01.04.2018, p. 646-650.

Research output: Contribution to journalArticle

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AU - Chusri, Sarunyou

AU - Sakarunchai, Ittichai

AU - Kositpantawong, Narongdet

AU - Panthuwong, Siripen

AU - Santimaleeworagun, Wichai

AU - Pattharachayakul, Sutthiporn

AU - Singkhamanan, Kamonnut

AU - Doi, Yohei

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