Tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii meningitis: Results of the Ege study

摘要

ObjectivesIn this study we retrospectively reviewedA. baumanniimeningitis cases treated with tigecycline including regimens and evaluated the efficacy of tigecycline in the therapy.Patients and Methods: Study was performed in seven tertiary-care educational hospitals from five cities of Turkey and one center from France. We extracted data and outcomes of all adult (aged >18) patients with culture provenA. baumanniimeningitis treated with tigecycline including antibiotic therapy until April 2016. ResultsA total of 23 patients (15 male and eight female) fulfilled our inclusion criteria. AllAcinetobacterstrains were carbapenem-resistant and susceptible to tigecycline. Six cases received tigecycline monotherapy while 17 received tigecycline including combination therapy (10 with colistin, 4 with netilmicin, 3 with amikacin, 4 with meropenem). Seven of 23 cases (30%) died during the tigecycline including therapy (1 in monotherapy, 4 in colistin, 2 in netilmicin, 1 amikacin, one case received tigecycline?+?netilmicin followed by tigecycline?+?colistin). Hence, overall end of treatment (EOT) success was 70%. However, since further 27% died due to additional nosocomial infections, overall clinical success (relieved symptoms at the EOT and one-month post-therapy survival without any relapse or reinfection) decreased to 43%. ConclusionWe conclude that tigecycline may be an alternative in the salvage treatment of nosocomial multidrug-resistantAcinetobacterspp. meningitis.Acinetobacterspp. Meningitis.