Combination of aztreonam, ceftazidime–avibactam and amikacin in the treatment of VIM-1 Pseudomonas aeruginosa ST235 osteomyelitis

Mularoni, Alessandra; Mezzatesta, Maria Lina; Pilato, Michele; Medaglia, Alice Annalisa; Cervo, Adriana; Bongiorno, Dafne; Aprile, Ausilia; Luca, Angelo; Stefani, Stefania; Grossi, Paolo

doi:10.1016/j.ijid.2021.05.085

Cited by 15 publications

(9 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since plasmids containing the MBL genome can also harbor genes that encode for several β-lactamases [17], a combination of aztreonam and avibactam provides broad coverage against a wide range of β-lactamase-producing Enterobacteriaceae. However, although a combination of aztreonam and avibactam has been shown to be effective against MBL-producing Enterobacterales [18], its activity against PA is less predictable due to multiple intrinsic and acquired resistance mechanisms that characterize multidrugresistant PA. Clinical case series describing MBL-PA infections treated with ceftazidimeavibactam combined with aztreonam have reported satisfying results [19,20]. Furthermore, a previous study, aimed at evaluating the time-killing profile of aztreonam and ceftazidime-avibactam in combination against MBL-producing P. aeruginosa, showed synergic and bactericidal activity in 80% of tested isolates [21].…”

Section: Discussionmentioning

confidence: 99%

The Use of Cefiderocol as Salvage Therapy in an Infant Receiving ECMO and Continuous Renal Replacement Therapy

Mercadante,

Tripiciano,

Romani

et al. 2023

Antibiotics

View full text Add to dashboard Cite

Background: Infections caused by antimicrobial-resistant (AMR) pathogens are increasing worldwide, representing a serious global public health issue with high morbidity and mortality rates The treatment of Pseudomonas aeruginosa (PA) infections has become a significant challenge due to its ability to develop resistance to many of the currently available antibiotics, especially in intensive care unit (ICU) settings. Among the very few therapeutic lines available against extensively drug-resistant (XDR)-PA and/or with difficult-to-treat resistance (DTR)-PA, cefiderocol is an injectable siderophore cephalosporin not licensed for use in pediatric patients. There are only a few case reports and two ongoing trials describing the administration of this cephalosporin in infants. Case presentation: This report describes the case of a critically ill 8-month-old girl affected by ventilator-associated pneumonia (VAP) infection complicated by bloodstream infection (BSI) sustained by VIM-producing PA. She was treated with cefiderocol as a salvage therapy during ECMO and CRRT support. Conclusions: In healthcare settings, treating multidrug-resistant, Gram-negative bacteria poses a serious challenge, especially in pediatric patients. Our findings suggest that cefiderocol can be considered as an off-label rescue therapy in selected pediatric cases.

show abstract

Section: Discussionmentioning

confidence: 99%

The Use of Cefiderocol as Salvage Therapy in an Infant Receiving ECMO and Continuous Renal Replacement Therapy

Mercadante,

Tripiciano,

Romani

et al. 2023

Antibiotics

View full text Add to dashboard Cite

show abstract

“…Regarding BJI, few cases have been reported (13,14), but favorable outcomes were reached with this association. Moreover, a case of VIM-producing Pseudomonas aeruginosa associated osteomyelitis successfully treated with ATM, CAZ-AVI, and amikacin was reported (18).…”

Section: Discussionmentioning

confidence: 99%

Case report: Continuous infusions of ceftazidime-avibactam and aztreonam in combination through elastomeric infusors for 12 weeks for the treatment of bone and joint infections due to metallo-β-lactamase producing Enterobacterales

et al. 2023

View full text Add to dashboard Cite

Among carbapenem-resistant Enterobacterales, metallo-beta-lactamase producing strains represent a growing therapeutic challenge. While the association of aztreonam and ceftazidime-avibactam has been investigated in recent years for the treatment of infections involving these strains, little to no clinical data support the use of this association for the treatment of bone and joint infections. We report two cases of complex bone and joint infections involving metallo-beta-lactamase-producing Enterobacterales, successfully treated at our referral center with aztreonam and ceftazidime-avibactam for 12 weeks in continuous infusions through elastomeric infusors.

show abstract

“…Clinical data on CAZ–AVI’s efficacy in treating BJIs are limited. Nonetheless, several reports mentioned that patients with osteomyelitis or arthritis caused by MDR/XDR-GNB were successfully treated with CAZ–AVI [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ].…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Ceftazidime-Avibactam as Osteomyelitis Therapy: A Miniseries and Review of the Literature

Mancuso,

Pipitò,

Rubino

et al. 2023

Antibiotics

View full text Add to dashboard Cite

Bone and joint infections (BJIs) caused by multidrug-resistant gram-negative bacteria are becoming a concern due to limited therapeutic options. Although not approved for these indications, an ever-growing amount of evidence supports the efficacy and safety of ceftazidime–avibactam as a therapy for osteomyelitis and prosthetic joint infections. Here, we present three cases of difficult-to-treat resistant Pseudomonas aeruginosa osteomyelitis that were successfully treated with ceftazidime–avibactam alone or in combination therapy with fosfomycin and amikacin. Ceftazidime–avibactam was prescribed at a daily dose of 2.5 g every 8 hours for 42 days in all cases. One potential drug-related adverse effect was observed, i.e., Clostridioides difficile infection, which occurred after fourteen days of treatment with ceftazidime–avibactam.

show abstract

Combination of aztreonam, ceftazidime–avibactam and amikacin in the treatment of VIM-1 Pseudomonas aeruginosa ST235 osteomyelitis

Cited by 15 publications

References 16 publications

The Use of Cefiderocol as Salvage Therapy in an Infant Receiving ECMO and Continuous Renal Replacement Therapy

The Use of Cefiderocol as Salvage Therapy in an Infant Receiving ECMO and Continuous Renal Replacement Therapy

Case report: Continuous infusions of ceftazidime-avibactam and aztreonam in combination through elastomeric infusors for 12 weeks for the treatment of bone and joint infections due to metallo-β-lactamase producing Enterobacterales

Ceftazidime-Avibactam as Osteomyelitis Therapy: A Miniseries and Review of the Literature

Contact Info

Product

Resources

About