Intrathecal (intraventricular) polymyxin B in the treatment of patients with meningoencephalitis by Acinetobacter baumanii and Pseudomonas aeruginosa

Excerpt

Intraventricular therapy (IVT) with polymyxin B (PolyB), an antibiotic with similar pharmacological action to colistin (PolyE), by external ventricular derivation (EVD) has the main goal of offering major bioavailability of the drug, since its use by intravenous and direct action are restricted by the blood-brain barrier, with penetration of only 25%. Pseudomonas aeruginosa is a Gram-negative bacterium, multidrug resistant, which has a characteristic of secreting exotoxin A. Along with Acinetobacter baumannii, it has expressed a great risk to the lives of patients with meningoencephalitis. The patient of the present report had arterial venous malformations followed by hemorrhagic stroke, which caused elevated intracranial pressure. The objective is to show an example of the effect of IVT PolyB in a patient with meningoencephalitis infection by multidrug-resistant Gram-negative bacteria (A. baumannii and P. aeruginosa), common in the ICU. …