Intrathecal/Intraventricular Colistin for Antibiotic-Resistant Bacterial CNS Infections in Pediatric Population: A Systematic Review
Central nervous system (CNS) infections constitute a life-threatening condition, especially in children. Treatment limitations exist for drug-resistant CNS bacterial infections. Inadequate CNS penetration and intravenous (IV) antibiotic treatment failure represent a major clinical challenge. However...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-03-01
|
| Series: | Tropical Medicine and Infectious Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2414-6366/7/3/41 |
| _version_ | 1797441263367094272 |
|---|---|
| author | Ibrahim Alnaami Zubaidah Alahmari |
| author_facet | Ibrahim Alnaami Zubaidah Alahmari |
| author_sort | Ibrahim Alnaami |
| collection | DOAJ |
| description | Central nervous system (CNS) infections constitute a life-threatening condition, especially in children. Treatment limitations exist for drug-resistant CNS bacterial infections. Inadequate CNS penetration and intravenous (IV) antibiotic treatment failure represent a major clinical challenge. However, patients with antibiotic-resistant bacterial CNS infections may benefit from intrathecal (IT) or intraventricular (IVT) colistin. The authors aimed to assess the safety and effectiveness of IT/IVT colistin therapy in the pediatric population, with or without other antibiotics, for the treatment of antibiotic-resistant CNS infections. A comprehensive literature search was conducted using the electronic databases of PubMed, Ovid, and Embase for relevant articles using the following terms: “Colistin”, “CNS infection”, and “Outcome”, as well as their combinations. The retrieved articles were filtered by age (Child), language (English), route of administration (IT/IVT), and species (Humans). The present systematic review comprised 20 articles that included 31 children (19; 61.2% were boys) with multidrug-resistant CNS infection. Their ages ranged from less than one month to 18 years (median: 9 months). <i>Acinetobacter baumannii</i> was the main causative organism in 22 patients (70.9%), and infection occurred mainly after neurosurgical interventions (83.8%). An external ventricular drain was inserted to administer colistin into the ventricular system in 29 cases (93.5%). The median duration for colistin therapy was 18 days. Twenty-three patients (74%) recovered, while five patients (16%) had residual disability, and three patients (10%) died. The authors concluded that IT/IVT colistin therapy is safe and effective as either the primary or adjunct treatment for antibiotic-resistant cases with CNS infection. |
| first_indexed | 2024-03-09T12:21:31Z |
| format | Article |
| id | doaj.art-1c7ebfab1cfb4593b0a1e48bfb856bf5 |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-03-09T12:21:31Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-1c7ebfab1cfb4593b0a1e48bfb856bf52023-11-30T22:40:10ZengMDPI AGTropical Medicine and Infectious Disease2414-63662022-03-01734110.3390/tropicalmed7030041Intrathecal/Intraventricular Colistin for Antibiotic-Resistant Bacterial CNS Infections in Pediatric Population: A Systematic ReviewIbrahim Alnaami0Zubaidah Alahmari1Department of Surgery, Division of Neurosurgery, King Khalid University, Abha 61421, Saudi ArabiaDepartment of Pediatric Neurosurgery, Khamis Mushait Maternity and Children Hospital, Khamis Mushait 61961, Saudi ArabiaCentral nervous system (CNS) infections constitute a life-threatening condition, especially in children. Treatment limitations exist for drug-resistant CNS bacterial infections. Inadequate CNS penetration and intravenous (IV) antibiotic treatment failure represent a major clinical challenge. However, patients with antibiotic-resistant bacterial CNS infections may benefit from intrathecal (IT) or intraventricular (IVT) colistin. The authors aimed to assess the safety and effectiveness of IT/IVT colistin therapy in the pediatric population, with or without other antibiotics, for the treatment of antibiotic-resistant CNS infections. A comprehensive literature search was conducted using the electronic databases of PubMed, Ovid, and Embase for relevant articles using the following terms: “Colistin”, “CNS infection”, and “Outcome”, as well as their combinations. The retrieved articles were filtered by age (Child), language (English), route of administration (IT/IVT), and species (Humans). The present systematic review comprised 20 articles that included 31 children (19; 61.2% were boys) with multidrug-resistant CNS infection. Their ages ranged from less than one month to 18 years (median: 9 months). <i>Acinetobacter baumannii</i> was the main causative organism in 22 patients (70.9%), and infection occurred mainly after neurosurgical interventions (83.8%). An external ventricular drain was inserted to administer colistin into the ventricular system in 29 cases (93.5%). The median duration for colistin therapy was 18 days. Twenty-three patients (74%) recovered, while five patients (16%) had residual disability, and three patients (10%) died. The authors concluded that IT/IVT colistin therapy is safe and effective as either the primary or adjunct treatment for antibiotic-resistant cases with CNS infection.https://www.mdpi.com/2414-6366/7/3/41CNS infectionchildrencolistin<i>Acinetobacter baumannii</i>intrathecalintraventricular |
| spellingShingle | Ibrahim Alnaami Zubaidah Alahmari Intrathecal/Intraventricular Colistin for Antibiotic-Resistant Bacterial CNS Infections in Pediatric Population: A Systematic Review Tropical Medicine and Infectious Disease CNS infection children colistin <i>Acinetobacter baumannii</i> intrathecal intraventricular |
| title | Intrathecal/Intraventricular Colistin for Antibiotic-Resistant Bacterial CNS Infections in Pediatric Population: A Systematic Review |
| title_full | Intrathecal/Intraventricular Colistin for Antibiotic-Resistant Bacterial CNS Infections in Pediatric Population: A Systematic Review |
| title_fullStr | Intrathecal/Intraventricular Colistin for Antibiotic-Resistant Bacterial CNS Infections in Pediatric Population: A Systematic Review |
| title_full_unstemmed | Intrathecal/Intraventricular Colistin for Antibiotic-Resistant Bacterial CNS Infections in Pediatric Population: A Systematic Review |
| title_short | Intrathecal/Intraventricular Colistin for Antibiotic-Resistant Bacterial CNS Infections in Pediatric Population: A Systematic Review |
| title_sort | intrathecal intraventricular colistin for antibiotic resistant bacterial cns infections in pediatric population a systematic review |
| topic | CNS infection children colistin <i>Acinetobacter baumannii</i> intrathecal intraventricular |
| url | https://www.mdpi.com/2414-6366/7/3/41 |
| work_keys_str_mv | AT ibrahimalnaami intrathecalintraventricularcolistinforantibioticresistantbacterialcnsinfectionsinpediatricpopulationasystematicreview AT zubaidahalahmari intrathecalintraventricularcolistinforantibioticresistantbacterialcnsinfectionsinpediatricpopulationasystematicreview |