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

Abstract : Objectives - In this study we retrospectively reviewed A. baumannii meningitis 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 proven A. baumannii meningitis treated with tigecycline including antibiotic therapy until April 2016. Results - A total of 23 patients (15 male and eight female) fulfilled our inclusion criteria. All Acinetobacter strains 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%. Conclusion - We conclude that tigecycline may be an alternative in the salvage treatment of nosocomial multidrug-resistant Acinetobacter spp. meningitis. Acinetobacter spp. Meningitis.
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Oguz Reşat Sipahi, Sinan Mermer, Tuna Demirdal, Aslıhan Candevir Ulu, Pierre Fillâtre, et al.. Tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii meningitis Results of the Ege study. Clinical Neurology and Neurosurgery, Elsevier, 2018, 172, pp.31-38. ⟨10.1016/j.clineuro.2018.06.008⟩. ⟨hal-01833940v2⟩

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