Clinical study of tigecycline combined with cefoperazone/sulbactam for treatment of intracranial infection with drugresistant Acinetobacter baumannii

Abstract:

ObjectiveTo evaluate clinic efficacy and safety of tigecycline combined with cefoperazone/sulbactam for treatment of intracranial infection with  drugresistant Acinetobacter baumannii(DRAB).Methods12 patients with DRAB intracranial infection admitted in a department of neurosurgery between January 2014 and  April 2015 were analyzed retrospectively, clinic efficacy and safety of  tigecycline combined with cefoperazone/sulbactam for treatment of DRAB intracranial infection were evaluated. ResultsAfter patients received tigecycline combined with cefoperazone/sulbactam for 1262 days（39.5 days on average）, clinical symptoms and signs（including body temperature,  signs of meningeal irritation）of most patients were significantly improved compared with before treatment，3 cases were cured, 5 were markedly effective, 4  abandoned or ineffective(death). The overall effective rate was 66.67%（8/12），mortality was 33.33%（4/12）；bacterial clearance rate of cerebrospinal fluid (CSF) was 83.33%(10/12). Causes of death: 2 were with failure of brain stem following  craniocerebral trauma，1was extensive parenchymal infection，1was recurrence of intracranial infection and formation of  brain abscess after withdrawing antimicrobial agents. No significant adverse reaction occurred during the treatment period. ConclusionOn the basis of keeping CSF drainage unobstructed, long course treatment of tigecycline combined with cefoperazone/sulbactam can effectively eliminate DRAB from CSF, and has a good safety.