Aztreonam/Clavulanic Acid in the Treatment of Serious Infections Caused by<i>Stenotrophomonas maltophilia</i>in Neutropenic Patients: Case Reports

Sánchez, José Elías García; López, Miguel Ángel; Castro, Asia; Pérez-Simón, José A.; Gutierrez, Norma G.; Martín, I. Trujillano; García-Rodríguez, J A

doi:10.1179/joc.1997.9.3.238

Cited by 13 publications

(3 citation statements)

References 5 publications

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“…21 Additionally, in two neutropenic cancer patients, one with refractory S. maltophilia bacteremia from a central line and the other with refractory S. maltophilia pneumonia, intravenous amoxicillinclavulanate plus aztreonam was used to achieve clinical cure. 15 Last, the potential utility of cefiderocol against S. maltophilia was evaluated in CREDIBLE-CR, a randomized study comparing cefiderocol to best available therapy in the treatment of carbapenemresistant gram-negative bacterial infections. 16 150 patients were included, 45% of whom had hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), or health care-associated pneumonia (HCAP), 31% had bloodstream infections, and 24% had urinary tract infections.…”

Section: Clinical Treatment Datamentioning

confidence: 99%

An Overview of the Treatment of Less Common Non–Lactose‐Fermenting Gram‐Negative Bacteria

et al. 2020

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Stenotrophomonas maltophilia, Burkholderia cepacia complex, Elizabethkingia spp., Chryseobacterium spp., Achromobacter spp., and Alcaligenes spp. are less‐common non–lactose‐fermenting bacteria that have emerged as important opportunistic pathogens. Patients at the highest risk for these infections include the immunocompromised, those with cystic fibrosis, and the critically ill. These opportunistic pathogens are frequently drug resistant through the expression of β‐lactamases, multidrug efflux pumps, aminoglycoside‐modifying enzymes, and target site alterations discussed in detail throughout this review. As a result, treatment is extremely challenging. For each pathogen, this review will examine the epidemiology, mechanisms of resistance, and in vitro and in vivo data including that for novel β‐lactam/β‐lactamase inhibitors and cefiderocol. Treatment recommendations are provided based on the available literature.

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Section: Clinical Treatment Datamentioning

confidence: 99%

An Overview of the Treatment of Less Common Non–Lactose‐Fermenting Gram‐Negative Bacteria

et al. 2020

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“…Etests were ordered to explore alternative antimicrobial options: ceftolozane-tazobactam, minimum inhibitory concentration (MIC) 0.5 mg/L; tigecycline MIC 2 mg/L; ceftazidime MIC 2 mg/L; and colistin MIC 0.5 mg/L. Due to concerns that monotherapy would not suffice and the need for simplified outpatient parenteral antimicrobial therapy to facilitate patient discharge, ceftolozane-tazobactam was favored [ 9 – 11 ].…”

Section: Case Presentationmentioning

confidence: 99%

Treatment of Polymicrobial Osteomyelitis with Ceftolozane-Tazobactam: Case Report and Sensitivity Testing of Isolates

Jolliff

Joson

et al. 2016

Case Reports in Infectious Diseases

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Stenotrophomonas maltophilia is an inherently multidrug resistant (MDR) opportunistic pathogen with many mechanisms of resistance. SENTRY studies reveal decreasing sensitivities of S. maltophilia to trimethoprim-sulfamethoxazole and fluoroquinolones. Ceftolozane-tazobactam (Zerbaxa, Merck & Co., Inc.) a novel intravenous combination agent of a third-generation cephalosporin and β-lactamase inhibitor was demonstrated to have in vitro activity against many Gram-positive, Gram-negative, and MDR organisms. Data for ceftolozane-tazobactam's use outside of Food and Drug Administration (FDA) approved indications has been limited thus far to two case reports which demonstrated its efficacy in pan-resistant Pseudomonas aeruginosa pneumonia. Herein, we describe the first published case of treatment of MDR S. maltophilia in polymicrobial osteomyelitis with long-term (>14 days) ceftolozane-tazobactam and metronidazole. Ceftolozane-tazobactam may offer a possible alternative for clinicians faced with limited options in the treatment of resistant pathogens including MDR S. maltophilia.

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“…Two patients with S. maltophilia infection are reported to have responded to aztreonam-clavulanate, 134 as did a neutropenic patient with cellulitis. 87 In catheterrelated infections, "locked-in" antibiotic therapy has been used successfully, 135 and anecdotal cases of resolution of foreign-device-associated infection with device removal but not appropriate antibiotic therapy have been reported.…”

Section: Clinical Experiencementioning

confidence: 99%

Stenotrophomonas MaltophiliaInfections

Dignani¹,

Grazziutti²,

Anaissie³

2003

Seminars in Respiratory and Critical Care Medicine

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Stenotrophomonas maltophilia is a ubiquitous, gram-negative organism that causes hospital-acquired infections. Persons often come in contact with S. maltophilia through environmental water sources, including hospital tap water or faucets, and it has been associated with nosocomial outbreaks of infection. S. maltophilia often infects debilitated persons and those with underlying medical conditions, including immunosuppression. Manifestations of infection include pneumonia, often in mechanically ventilated patients, bacteremia, skin and soft tissue infection, urinary tract infection, and endocarditis. Treatment of S. maltophilia infection is difficult because the organism is resistant to a number of agents typically used for hospital-acquired infections. In vitro and clinical data indicate that trimethoprim-sulfamethoxazole is the agent of choice. Beta-lactamase inhibitors such as clavulanate are also active, and combination therapy may be indicated for certain serious infections due to S. maltophilia.

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Aztreonam/Clavulanic Acid in the Treatment of Serious Infections Caused byStenotrophomonas maltophiliain Neutropenic Patients: Case Reports

Cited by 13 publications

References 5 publications

An Overview of the Treatment of Less Common Non–Lactose‐Fermenting Gram‐Negative Bacteria

An Overview of the Treatment of Less Common Non–Lactose‐Fermenting Gram‐Negative Bacteria

Treatment of Polymicrobial Osteomyelitis with Ceftolozane-Tazobactam: Case Report and Sensitivity Testing of Isolates

Stenotrophomonas MaltophiliaInfections

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