Successful Treatment of <scp>MDR</scp> <i>Acinetobacter baumannii</i> Meningitis in a Young Adult Patient With Intraventricular and Intravenous Polymyxin B‐Tigecycline Based Combinations: A Case Report

Multiple drug resistance to <i>Acinetobacter baumannii</i> infection treatment is a great challenge for neuro-intensivists due to poor drug penetration through the blood-brain barrier (BBB). Fortunately, the intraventricular administration of polymyxin-B and tigecycline seems to be effective; there are few case reports demonstrating the effectiveness of such treatments. Here, we report the case of a 24-year-old male who presented with fever and neck rigidity after intracranial drainage following lung infection caused by MDR <i>Acinetobacter baumannii</i>. Due to the presence of turbid CSF, the administration of the intrathecal (ITH) route polymyxin-B and tigecycline is not possible. In this situation, the neuro-intensivist decided to start intraventricular tigecycline and polymyxin-B administration along with IV tigecycline and polymyxin-B via the intraventricular route, which was feasible because the patient had an external ventricular drain (EVD) due to obstructive hydrocephalus caused by the neurosurgeon after excision of the tumor.