CO27 | Pseudomonas aeruginosa MDR strain bacteraemia successfully treated with piperacillin/tazobactam: when beta-lactam continuous infusion, therapeutic drug monitoring and fosfomycin combination make everything easier
Year: 2025
Type: conference-abstract
Abstract: Premises: Pseudomonas aeruginosa is a common cause of healthcare-associated infections. In case of sepsis, beta-lactam antibiotics continuous infusion (CI) and therapeutic drug monitoring (TDM) guided therapy, allow to reach a higher rate of clinical and microbiological cure. Fosfomycin is known to retain good antibiofilm activity and a potential synergistic effect when added to beta-lactams, even against P. aeruginosa MDR strains. Case description: A 62 years old man, affected by squamous cell carcinoma extended to the pelvic region, after an attempt of epicistostomy placement, developed fever with high C-reactive protein (CRP 268.74 mg/L) and procalcitonin (PCT 39.32 ng/mL) values. Urine and blood cultures were taken and empiric iv piperacillin/tazobactam 18gr CI was started; cause of fever persistence, beta-lactam dosage was brought to 20.5gr and iv fosfomycin 12gr CI was added. Cultures revealed P. aeruginosa growth with MDR profile: cefepime I8 mg/L, ceftazidime I8 mg/L, ceftolozan-tazobactam S1 mg/L, ciprofloxacin I0.5 mg/L, fosfomycin R>64 mg/L, meropenem R16 mg/L, piperacillina-tazobactam R32 mg/L. No organ involvement was documented. Due to persistent apyrexia, CRP, PCT and blood culture negativization, we maintained the same antibiotic treatment, despite of resistance profile. Piperacillin/tazobactam TDM showed a concentration of 72.55 mg/L, more than twice the MIC value for P. aeruginosa. Conclusions: Piperacillin/tazobactam CI, in association with fosfomycin and TDM, could be a good choice, even in case of P. aeruginosa MDR infection without organ involvement.
Source: Italian Journal of Medicine
Authors: Vo Van Kha, Tran Thi Huong Ly, Pham Thi Thanh Hoa, Vo Huynh Nhu, Damas Hendriansyah, Nusratuddin Abdullah, Rudy B. Leonardy, Mardiah Tahir, Samrichard Rambulangi, Firdaus Hamid, Filomena Pietrantonio, Vera Kopsaj, Francesco Rosiello, Aurora Tomassoni, Luca Moriconi, Donatella Padua, Kiki Rizki Amelia, Efendi Lukas, Nurbani Bangsawan, Isharyah Sunarno, Retno Budiarti Farid, Sriwijaya Qadar, Rabab H. Elshaikh, Ashok Kumar Sah, Abdelrahman Mohamed Abukanna, Abdulrahman Algarni, Ammar Abdelmola, Hussam Ali Osman, Tagwa Yousif Elsayed Yousif, Elryah I. Ali, Hiba Ali, Ayman Hussein Alfeel, Thanh Long Nguyen, Victor Storm, Lam Toi Phung, Cong Thien Le, Thi Thu Ha Le, Thi Hoa Nguyen, Son Tung Vu, Thien Thang Tran, Minh Hanh Vu, Van Tuan Nguyen, Francesco Ventrella, Anna Belfiore, Antonio Greco, Franco Mastroianni, Salvatore Lenti, Domenico Ruggiero, Michele Cannone, Vincenzo Ostilio Palmieri, Massimo Errico, Giuseppe Mancia, Guido Grassi, Sverre E. Kjeldsen
Language: English
Subfield: Pharmacology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413772352