Is intraventricular colistin an effective and safe treatment for post‐surgical ventriculitis in the intensive care unit?

  title={Is intraventricular colistin an effective and safe treatment for post‐surgical ventriculitis in the intensive care unit?},
  author={Dimitrios Karakitsos and Elisabeth Paramythiotou and Georgios Samonis and Andr{\'e}as Karabinis},
  journal={Acta Anaesthesiologica Scandinavica},
Sir, Post-surgical ventriculitis caused by Gram-negative bacteria may be difficult to treat and is associated with high mortality as a result of the emergence of multiresistant strains (1). Colistin is a polymyxin used successfully against Gram-negative bacteria in the past. However, it was abandoned because of reported toxicity (2). Limited studies have reported the successful treatment of multiresistant Acinetobacter baumannii or Pseudomonas aeruginosa ventriculitis after either intravenous… 

Multidrug-resistant Acinetobacter baumannii ventriculitis: successful treatment with intraventricular colistin

Experience suggests that intraventricular colistin is a potentially effective and safe therapy for the treatment of multidrug-resistant A. baumannii central nervous system infections.

Intraventricular or intrathecal colistin for the treatment of central nervous system infections caused by multidrug-resistant Gram-negative bacteria

The clinical and experimental data supporting the use of intraventricular (IVT) or intrathecal (IT) colistin against multidrug-resistant Gram-negative infections of the central nervous system are described and evaluated and recommendations are provided based on the available evidence.

Local complications of adjunct intrathecal antibiotics for nosocomial meningitis associated with gram-negative pathogens: a meta-analysis

Intraventricular/intrathecal IVT/IT antibiotics for the treatment of ventriculitis/meningitis associated with gram-negative pathogens was associated with moderate morbidity, mainly attributed to chemical meningitis and seizures.

Intrathecal/intraventricular colistin in external ventricular device-related infections by multi-drug resistant Gram negative bacteria: case reports and review

It is concluded that the intrathecal/intraventricular administration of colistin is a safe and effective option to treat central nervous system infections caused by multidrug-resistant Gram-negative bacteria.

Treatment Options for Multidrug-Resistant Acinetobacter Species

The cumulative experience with and the evidence for treating infections caused by multidrug-resistant Acinetobacter spp.

Intrathecal or intraventricular colistin: a review.

  • O. BargiacchiF. D. De Rosa
  • Medicine, Biology
    Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive
  • 2016
This work reviews the literature of intrathecal/intraventricular use of colistin, comprehensive of both pharmacokinetic data and clinical experiences and concludes that when CNS infections are caused by multi-drug resistant Gram-negative bacteria, intr Athecal colists are considered an effective and safe option.

Colistin and Acute Renal Failure: A Centre’s Experience

This study highlights the need to understand more fully the rationale behind the continued use of Efendi's Law in the treatment of central giant cell granuloma.

Exceptional ( inherently colistin resistant ) Gram negative bacteria

  • Chemistry
  • 2010
Systematic (IUPAC) name

Antibiotikaanwendung und Resistenzentwicklung

In den Jahren der ersten Anwendung der neu entwickelten Antibiotika sprach man von Wundermitteln und glaubte, man hatte die Zauberkugeln im Sinne Paul Ehrlichs gefun− den und damit den Sieg uber die bakteriellen Infek− tionskrankheiten erreichen konnen.



Intrathecal colistin for treatment of highly resistant Pseudomonas ventriculitis. Case report and review of the literature.

The case of a 51-year-old woman who endured protracted hospitalization and required multiple surgeries including placement of a ventriculoperitoneal shunt is presented, demonstrating intermediate sensitivity to amikacin and full resistance to all other antibiotics tested.

Intrathecal Colistin and Sterilization of Resistant Pseudomonas Aeruginosa Shunt Infection

2 cases of multidrug-resistant Pseudomonas aeruginosa meningitis and ventriculo-peritoneal shunt infection successfully sterilized with intrathecal colistin 10 mg/day after development of nephrotoxicity associated with intravenous administration.

Nosocomial acinetobacter meningitis secondary to invasive procedures: report of 25 cases and review.

This series is the largest of acinetobacter meningitis reported hitherto and constitutes an increasing threat for patients, especially those receiving antimicrobial therapy in intensive care units who are being maintained by various life-support systems.

Cerebrospinal Fluid Penetration and Pharmacokinetic/Pharmacodynamic Parameters of Intravenously Administered Colistin in a Case of Multidrug-Resistant Acinetobacter baumannii Meningitis

Described here is a case of meningitis caused by multidrug-resistant Acinetobacter baumannii susceptible only to colistin, which was treated successfully with intravenous colistin sulfomethate sodium

General State Hospital of Athens Greece e-mail:

    Cerebrospinal fluid penetration and pharmacokinetic parameters of intravenously administered colistin in a case of multidrug resistant Acinetobacter baumannii meningitis

    • Eur J Clin Microbiol Infect Dis
    • 2002