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.
journal_name
Int J Antimicrob Agentsjournal_title
International journal of antimicrobial agentsauthors
Chusri S,Sakarunchai I,Kositpantawong N,Panthuwong S,Santimaleeworagun W,Pattharachayakul S,Singkhamanan K,Doi Ydoi
10.1016/j.ijantimicag.2017.12.002subject
Has Abstractpub_date
2018-04-01 00:00:00pages
646-650issue
4eissn
0924-8579issn
1872-7913pii
S0924-8579(17)30436-3journal_volume
51pub_type
杂志文章abstract::The in vitro activity of piperacillin alone or titrated with a constant concentration of 4 mug/ml tazobactam was evaluated against 3962 baseline pathogens isolated from 1899 patients enrolled in 9 clinical trial studies in North America. Tazobactam increased susceptibility rates of piperacillin for Enterobacteriaceae ...
journal_title:International journal of antimicrobial agents
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journal_title:International journal of antimicrobial agents
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journal_title:International journal of antimicrobial agents
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journal_title:International journal of antimicrobial agents
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journal_title:International journal of antimicrobial agents
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journal_title:International journal of antimicrobial agents
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journal_title:International journal of antimicrobial agents
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journal_title:International journal of antimicrobial agents
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pub_type: 杂志文章
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更新日期:1991-01-01 00:00:00
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journal_title:International journal of antimicrobial agents
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更新日期:1997-09-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
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更新日期:1994-03-01 00:00:00
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journal_title:International journal of antimicrobial agents
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更新日期:2011-06-01 00:00:00
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更新日期:2020-01-01 00:00:00
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journal_title:International journal of antimicrobial agents
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doi:10.1016/j.ijantimicag.2013.04.014
更新日期:2013-07-01 00:00:00
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journal_title:International journal of antimicrobial agents
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journal_title:International journal of antimicrobial agents
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