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  • Successful treatment of ceftazidime-resistant Klebsiella pneumoniae ventriculitis with intravenous meropenem and intraventricular polymyxin B: case report and review.

Successful treatment of ceftazidime-resistant Klebsiella pneumoniae ventriculitis with intravenous meropenem and intraventricular polymyxin B: case report and review.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (1999-08-19)
S Segal-Maurer, N Mariano, A Qavi, C Urban, J J Rahal
ABSTRACT

Increasing prevalence of multidrug-resistant gram-negative organisms has led to a rise in clinically significant infections with these organisms and an increasing therapeutic dilemma. We present a case of a neurosurgical patient who developed ventriculoperitoneal shunt-associated ventriculitis due to ceftazidime-resistant Klebsiella pneumoniae susceptible to cefepime, imipenem, meropenem, and polymyxin B only. Successful management was accomplished by removal of the shunt and therapy with systemic meropenem and intraventricular polymyxin B. Rapid cerebrospinal fluid (CSF) sterilization occurred, with CSF bactericidal titers of 1:32 to 1:128. Polymyxin B should be considered as adjunctive therapy for life-threatening multidrug-resistant gram-negative infections. Prior literature on use of intrathecal polymyxin B in therapy for meningitis supports its potential efficacy.

MATERIALS
Product Number
Brand
Product Description

Ceftazidime, European Pharmacopoeia (EP) Reference Standard
USP
Ceftazidime pentahydrate, United States Pharmacopeia (USP) Reference Standard
Ceftazidime for peak identification, European Pharmacopoeia (EP) Reference Standard