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Updated: Aug 16, 2025
Intraventricular Drug Delivery and Sampling for Pharmacokinetics and Pharmacodynamics Study
Published on: March 31, 2022
Intrathecal or Intraventricular Tigecycline Therapy for Central Nervous System Infection Associated with
Ning Du1, En-Qiang Mao2, Zhi-Tao Yang2
1National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, People's Republic of China.
Purpose:
Infection with carbapenem-resistant Klebsiella pneumoniae (CRKP) is a great challenge. Central nervous system (CNS) infection caused by CRKP is rarely reported, and effective treatment is limited. Thus, this study aimed to assess intrathecal (IT) or intraventricular (IVT) injection of tigecycline for clearing infection with CRKP in CNS.
Patients And Methods:
Two patients who had intracranial infection with CRKP after craniotomy were treated in our institution and analyzed retrospectively, summarizing their therapeutic schedules.
Results:
They all had a fever with the positive results of cerebrospinal fluid (CSF) test, and CSF culture showed positive for CPKP, which was sensitive only to tigecycline. In addition, the MIC of polymyxin B was not tested due to the limited laboratory conditions. After IT or IVT injection of tigecycline treatment, the temperature of the patients became normal in 3 days, with normal levels of white blood cells, protein, glucose and chlorine concentrations in the CSF. Crucially, twice CSF cultures also became negative with no clinical symptoms of intracranial infection after IT or IVT injection of tigecycline treatment. Moreover, there were no adverse drug reactions observed.
Conclusion:
IT or IVT injection of tigecycline may be a bright choice to control intracranial infection with CRKP.
Insights
Intrathecal or intraventricular tigecycline effectively treated central nervous system infections caused by carbapenem-resistant Klebsiella pneumoniae. Both patients achieved negative cultures and symptom resolution without adverse effects.
Area of Science:
- Infectious Diseases
- Neuroscience
- Pharmacology
Background:
- Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant global health threat.
- Central nervous system (CNS) infections by CRKP are rare and challenging to treat.
- Limited effective therapeutic options exist for CRKP CNS infections.
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