Optimization of Aztreonam in Combination With Ceftazidime/Avibactam in a Cystic Fibrosis Patient With Chronic Stenotrophomonas maltophilia Pneumonia Using Therapeutic Drug Monitoring: A Case Study.

Authors :: Cowart MC
Ferguson CL
Source :: Therapeutic drug monitoring [Ther Drug Monit] 2021 Apr 01; Vol. 43 (2), pp. 146-149.
Publication Year :: 2021
Abstract: Abstract: In this clinician-therapeutic drug monitoring (TDM) consultant interaction, the authors describe the use of TDM in an 11-year-old female patient with cystic fibrosis receiving ceftazidime/avibactam and aztreonam for the treatment of persistent pulmonary exacerbations caused by Stenotrophomonas pneumonia. Serum drug concentrations at a steady state confirmed inadequate antimicrobial exposure, and continuous infusions of both ceftazidime/avibactam and aztreonam were required to optimize the percentage of time when free drug remained above the minimum inhibitory concentration (MIC), known as fT > MIC. After dose adjustment, this continuous infusion strategy resulted in 100% target attainment for fT > MIC. This case illustrates the importance of TDM, and the logistical issues encountered with the use of alternative dosing strategies in pediatric patients with CF.<br />Competing Interests: The authors declare no conflict of interest.<br /> (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Subjects :: Anti-Bacterial Agents therapeutic use
Child
Drug Combinations
Drug Monitoring
Female
Humans
Microbial Sensitivity Tests
Stenotrophomonas maltophilia
Azabicyclo Compounds therapeutic use
Aztreonam therapeutic use
Ceftazidime therapeutic use
Cystic Fibrosis complications
Cystic Fibrosis drug therapy
Pneumonia, Bacterial drug therapy
Pneumonia, Bacterial microbiology

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