Open AccessIntra-pleural colistin methanesulfonate therapy for pleural infection caused by carbapenem-resistant Acinetobacter baumannii: a successful case report
Author(s) -
Muhammad Asim Rana,
Basheer Abd El Rahaman,
Ahmed Mady,
Mohammed Al Odat,
Abdurehman Al Harthy,
Omar El Sayed Ramadan,
Shahzad A. Mumtaz,
Ali S. Omrani
Publication year - 2014
Publication title -
infectious disease reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.487
H-Index - 17
ISSN - 2036-7449
DOI - 10.4081/idr.2014.5413
Subject(s) - colistin , medicine , acinetobacter baumannii , imipenem , carbapenem , pneumonia , pleurisy , antimicrobial , microbiology and biotechnology , antibiotics , pleural effusion , surgery , bacteria , pseudomonas aeruginosa , antibiotic resistance , biology , genetics
Infections caused by carbapenem-resistant, Gram-negative bacteria are an increasing clinical challenge, since the antimicrobial treatment options are often limited to colistin methanesulfonate. No data are available regarding the pharmacokinetics of colistin in pleural fluid. We report the case of a 92-year old man with ventilator-associated pneumonia and pleurisy caused by Acinetobacter baumannii and Escherichia coli, which were both multidrug-resistant. After an unsuccessful treatment with intravenous colistin methanesulfonate and imipenem-cilastatin, the addition of intra-pleural colistin methanesulfonate to the intravenous treatment led to a prompt clinical, radiological and microbiological resolution. This is the first report of a successful use of intra-pleural colistin in the literature. The intra-pleural colistin therapy should be considered in selected cases of pleurisy caused by multi-resistant Gram-negative bacteria
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