1. Ceftolozane-tazobactam in combination with fosfomycin for treatment of MDR/XDR P. aeruginosa infective endocarditis
- Author
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A. Prescott, S. Kennedy, P. Howard, T. Collyns, M.H. Gilleece, F. Pirone, M.W. Baig, C. Donnellan, and J.A.T. Sandoe
- Subjects
Ceftolozane-tazobactam ,Multi-drug resistant ,Extensively drug resistant ,Pseudomonas aeruginosa ,Infective endocarditis ,Intravascular catheter-related bloodstream infection ,Infectious and parasitic diseases ,RC109-216 - Abstract
Background: Infective endocarditis (IE) due to multi-drug (MDR) and extensively drug-resistant (XDR) Pseudomonas aeruginosa is rare. MDR P. aeruginosa infections are increasingly reported worldwide, and the choice of effective antimicrobials is limited. Ceftolozane-tazobactam is a new antimicrobial combination with activity against many resistant strains of P. aeruginosa, but there are limited data on its use in complex infections. Methods: We present the first reported cases of XDR P. aeruginosa IE and MDR P. aeruginosa intravascular catheter-related bloodstream infection [CRBSI] with possible IE to be treated with ceftolozane-tazobactam in combination with other agents. Results: Patient 1 completed seven weeks treatment with ceftolozane-tazobactam and fosfomycin, in combination with valve replacement, for XDR P. aeruginosa IE and is 2 year post-treatment without signs of relapse. Patient 2 completed 4 weeks treatment with ceftolozane-tazobactam and fosfomycin for MDR P. aeruginosa intravascular CRBSI with possible IE and went 8 months before MDR P. aeruginosa was cultured again from a line culture and tip. Conclusions: These cases highlight the difficulties of managing IE caused by MDR and XDR P. aeruginosa infections and indicate that ceftolozane-tazobactam may be effective when there are no alternative beta-lactams.
- Published
- 2019
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