脑室内注射替加环素治疗开颅术后多重耐药细菌性脑膜炎：一例报告
Intraventricular administration of tigecycline for the treatment of multidrug-resistant bacterial meningitis after craniotomy: a case report.
作者信息
Wu Yuanxing, Chen Kai, Zhao Jingwei, Wang Qiang, Zhou Jianxin
机构信息
a Pulmonary and Critical Care Medicine , Beijing Anzhen Hospital, Capital Medical University , Beijing , P.R. China.
b Intensive Care Unit , Beijing Tiantan Hospital, Capital Medical University , Beijing , P.R. China.
出版信息
J Chemother. 2018 Feb;30(1):49-52. doi: 10.1080/1120009X.2017.1338846. Epub 2017 Jun 14.
BACKGROUND
Intracranial infections, especially multidrug-resistant (MDR) bacterial meningitis, are one of the most severe complications after craniotomy and may greatly impact patient outcomes.
CASE PRESENTATION
We report a case of severe MDR Klebsiella pneumonia meningitis after craniotomy that was treated with three different dosages of tigecycline (Pfizer, New York, NY, U.S.A.)via a combined intravenous (IV) and intracerebroventricular (ICV) administration. Here, we discuss the pharmacokinetics (PK) of a combined IV and ICV tigecycline administration for a patient with an intracranial infection after craniotomy.
CONCLUSION
In the present case, three different dosages of tigecycline were administered: 49 mg IV plus 1 mg ICV q12 h, 45 mg IV plus 5 mg ICV q12 h, 40 mg IV plus 10 mg ICV q12 h. The combined IV and ICV administration might improve CSF tigecycline concentrations, and in this case, the methods of administration were safe and effective.
背景
颅内感染，尤其是多重耐药（MDR）细菌性脑膜炎，是开颅术后最严重的并发症之一，可能会极大地影响患者的预后。
病例报告
我们报告了1例开颅术后发生的严重多重耐药肺炎克雷伯菌脑膜炎病例，通过静脉（IV）和脑室内（ICV）联合给药的方式使用了三种不同剂量的替加环素（辉瑞公司，美国纽约州纽约市）进行治疗。在此，我们讨论了开颅术后颅内感染患者静脉和脑室内联合使用替加环素的药代动力学（PK）情况。
结论
在本病例中，使用了三种不同剂量的替加环素：静脉注射49mg加脑室内注射1mg，每12小时一次；静脉注射45mg加脑室内注射5mg，每12小时一次；静脉注射40mg加脑室内注射10mg，每12小时一次。静脉和脑室内联合给药可能会提高脑脊液中替加环素的浓度，在本病例中，给药方法安全有效。
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