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Published on: April 18, 2019

Amikacin and colistin for treatment of Acinetobacter baumannii meningitis

Eric J Fulnecky1, Donald Wright, W Michael Scheld

  • 1Section of Infectious Diseases, Washington Hospital Center, 110 Irving Street, Washington, DC 20010, USA.

The Journal of Infection
|May 26, 2005
PubMed

Insights

A case of meningitis caused by multidrug-resistant Acinetobacter baumannii was successfully treated with combination therapy. Intravenous and intrathecal amikacin plus intravenous colistin achieved positive clinical and microbiological results.

Area of Science:

  • Infectious Diseases
  • Neuroscience
  • Pharmacology

Background:

  • Post-surgical meningitis poses a significant clinical challenge, particularly when caused by multidrug-resistant pathogens.
  • Acinetobacter baumannii is an opportunistic pathogen frequently associated with hospital-acquired infections and meningitis.

Observation:

  • A 52-year-old male patient presented with post-surgical meningitis.
  • The meningitis was caused by a multidrug-resistant strain of Acinetobacter baumannii.
  • Initial treatment with intravenous amikacin and imipenem failed to resolve the infection.

Findings:

  • Combination therapy involving intravenous and intrathecal (IT) amikacin, along with intravenous colistin, was initiated.
  • This intensive treatment regimen led to successful clinical recovery.
  • Microbiological eradication of Acinetobacter baumannii was achieved.

Implications:

  • This case highlights the potential efficacy of combination therapy with intrathecal amikacin and intravenous colistin for treating refractory multidrug-resistant Acinetobacter baumannii meningitis.
  • Intrathecal administration of antibiotics may be a viable strategy for CNS infections when conventional routes are insufficient.
  • Further research into optimized treatment strategies for resistant bacterial meningitis is warranted.

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