Efficacy of intraventricular amikacin treatment in pan-resistant Pseudomonas aeruginosa postsurgical meningitis

BACKGROUND: We describe a case of pan-resistant Pseudomonas aeruginosa postsurgical meningitis associated with the presence of an external ventricular device. We changed therapy twice; finally, by using amikacin and a continuous infusion of cefepime, we obtained clinical improvement. CASE PRESENTATI...

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Autores principales: Molinaro, Mariadelfina, Morelli, Paola, De Gregori, Manuela, De Gregori, Simona, Giardini, Ilaria, Tordato, Federica, Monzillo, Vincenzina, Pocaterra, Daria, Casari, Erminia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128265/
https://www.ncbi.nlm.nih.gov/pubmed/30214257
http://dx.doi.org/10.2147/IDR.S169271
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author Molinaro, Mariadelfina
Morelli, Paola
De Gregori, Manuela
De Gregori, Simona
Giardini, Ilaria
Tordato, Federica
Monzillo, Vincenzina
Pocaterra, Daria
Casari, Erminia
author_facet Molinaro, Mariadelfina
Morelli, Paola
De Gregori, Manuela
De Gregori, Simona
Giardini, Ilaria
Tordato, Federica
Monzillo, Vincenzina
Pocaterra, Daria
Casari, Erminia
author_sort Molinaro, Mariadelfina
collection PubMed
description BACKGROUND: We describe a case of pan-resistant Pseudomonas aeruginosa postsurgical meningitis associated with the presence of an external ventricular device. We changed therapy twice; finally, by using amikacin and a continuous infusion of cefepime, we obtained clinical improvement. CASE PRESENTATION: A female patient, who underwent surgery for a cavernous angioma, presented with meningitis. Cerebrospinal fluid culture revealed a multidrug-resistant Pseudomonas aeruginosa, initially sensitive only to colistin. We successfully used intrathecal amikacin and intravenous cefepime continuous infusion plus intravenous amikacin after two previous ineffective therapeutic approaches. CONCLUSION: The evaluation of the antibiotic concentration and the bactericidal activity in cerebrospinal fluid may contribute to the choice of the drug in cases of multidrug-resistant meningitis.
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spelling pubmed-61282652018-09-13 Efficacy of intraventricular amikacin treatment in pan-resistant Pseudomonas aeruginosa postsurgical meningitis Molinaro, Mariadelfina Morelli, Paola De Gregori, Manuela De Gregori, Simona Giardini, Ilaria Tordato, Federica Monzillo, Vincenzina Pocaterra, Daria Casari, Erminia Infect Drug Resist Case Report BACKGROUND: We describe a case of pan-resistant Pseudomonas aeruginosa postsurgical meningitis associated with the presence of an external ventricular device. We changed therapy twice; finally, by using amikacin and a continuous infusion of cefepime, we obtained clinical improvement. CASE PRESENTATION: A female patient, who underwent surgery for a cavernous angioma, presented with meningitis. Cerebrospinal fluid culture revealed a multidrug-resistant Pseudomonas aeruginosa, initially sensitive only to colistin. We successfully used intrathecal amikacin and intravenous cefepime continuous infusion plus intravenous amikacin after two previous ineffective therapeutic approaches. CONCLUSION: The evaluation of the antibiotic concentration and the bactericidal activity in cerebrospinal fluid may contribute to the choice of the drug in cases of multidrug-resistant meningitis. Dove Medical Press 2018-09-03 /pmc/articles/PMC6128265/ /pubmed/30214257 http://dx.doi.org/10.2147/IDR.S169271 Text en © 2018 Molinaro et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Case Report
Molinaro, Mariadelfina
Morelli, Paola
De Gregori, Manuela
De Gregori, Simona
Giardini, Ilaria
Tordato, Federica
Monzillo, Vincenzina
Pocaterra, Daria
Casari, Erminia
Efficacy of intraventricular amikacin treatment in pan-resistant Pseudomonas aeruginosa postsurgical meningitis
title Efficacy of intraventricular amikacin treatment in pan-resistant Pseudomonas aeruginosa postsurgical meningitis
title_full Efficacy of intraventricular amikacin treatment in pan-resistant Pseudomonas aeruginosa postsurgical meningitis
title_fullStr Efficacy of intraventricular amikacin treatment in pan-resistant Pseudomonas aeruginosa postsurgical meningitis
title_full_unstemmed Efficacy of intraventricular amikacin treatment in pan-resistant Pseudomonas aeruginosa postsurgical meningitis
title_short Efficacy of intraventricular amikacin treatment in pan-resistant Pseudomonas aeruginosa postsurgical meningitis
title_sort efficacy of intraventricular amikacin treatment in pan-resistant pseudomonas aeruginosa postsurgical meningitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128265/
https://www.ncbi.nlm.nih.gov/pubmed/30214257
http://dx.doi.org/10.2147/IDR.S169271
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