Continuous intrathecal pump infusion of baclofen with antibiotic drugs for treatment of pump-associated meningitis. Case report.
Intrathecal baclofen administered by means of an implantable pump is being increasingly used for successful treatment of spasticity. Meningitis following intrathecally administered baclofen is a rare but serious complication that is difficult to treat without removal of the pump. Because success rates with intravenously administered antibiotic drugs for the treatment of meningitis have been low, intrathecal administration of antibiotic agents is often required to eradicate the pathogen. The authors report the case of a patient in whom Staphylococcus epidermidis meningitis developed after insertion of an intrathecal baclofen pump. The patient was successfully treated by intrathecal coadministration of vancomycin and baclofen.
Zed
P J
PJ
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada.
Stiver
H G
HG
Devonshire
V
V
Jewesson
P J
PJ
Marra
F
F
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D001418:Baclofen / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D008581:Meningitis / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D016472:Motor Neuron Disease / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D009128:Muscle Spasticity / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D016459:Prosthesis-Related Infections / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D013212:Staphylococcus epidermidis / Q000187:drug effects; D014640:Vancomycin / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics
D000900:Anti-Bacterial Agents; D014640:Vancomycin; D001418:Baclofen