Successful treatment of Acinetobacter meningitis with intrathecal polymyxin E

Departments of 1Neurosurgery; 2Infectious Diseases, Soroka Medical Center and Ben Gurion Center for Health Sciences, P.O. Box 151, Beer Sheva, 84101, Israel Sir, Post-neurosurgical meningitis is a serious complication. When this disease is caused by a multidrug-resistant pathogen, the management of such a case is challenging. Multidrug-resistant Acinetobacter baumanii has become one of the more common nosocomial pathogens in hospitals. Infections caused by this bacterium are more common in patients with severe underlying diseases, and after multiple courses of antibiotic treatment.1 When the infection involves the meninges, the choice of an antibiotic is further limited by the blood–brain barrier. Intrathecal treatment is often the last resort in such cases.2 Polymyxins have not been used frequently, and in cases of multiple resistance, might be one of the only options. This class of antibiotic has been given intrathecally only to very few patients.3,4 We present a case of Acinetobacter meningitis, cured by intrathecal polymyxin E.