Combination Therapy with Ceftazidime-Avibactam and Amikacin for Multidrug-Resistant Pseudomonas aeruginosa Infection with Fulminant Myocarditis in a Younger Patient: A Case Report and Literature Review

Abstract

Introduction: Fulminant myocarditis is a life-threatening disease among young patients. Pseudomonas aeruginosa is distributed in nature and is often spread as an opportunistic pathogen to cause hospital-acquired infections in patients with underlying diseases and low immunity. Case Presentation: This report presented a case of a 28-year-old woman with fulminant myocarditis followed by P. aeruginosa infection. After hospitalization, she received veno-arterial extracorporeal membrane oxygenation (ECMO) and continuous renal replacement treatment (CRRT). Initially, piperacillin sodium tazobactam combined with amikacin was used for anti-infection therapy, which had a poor clinical effect. Subsequently, it was recommended to use ceftazidime-avibactam and amikacin for treatment. Finally, the infection index of the patient returned to normal. Conclusions: It is necessary to select correct and effective drugs according to etiology, considering the influence of ECMO and CRRT on the patient’s antimicrobial pharmacokinetics/pharmacodynamics (PK/PD). This case could provide a reference for safe and rational drug use in clinical practice.