• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Infectious Diseases and Therapy >Successful Treatment of Multi-Drug Resistant Pseudomonas aeruginosa Bacteremia with the Recommended Renally Adjusted Ceftolozane/Tazobactam Regimen
【24h】

Successful Treatment of Multi-Drug Resistant Pseudomonas aeruginosa Bacteremia with the Recommended Renally Adjusted Ceftolozane/Tazobactam Regimen

机译：推荐的肾调节头孢洛赞/他唑巴坦疗法成功治疗多药耐药的铜绿假单胞菌细菌血症

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Introduction Ceftolozane/tazobactam (C/T) is a novel antibiotic approved for complicated intra-abdominal and urinary tract infections caused by Gram-positive and Gram-negative organisms, including some MDR strains. Little is known about the use of this agent for treatment of bacteremia and even less so about the appropriateness of the renally defined regimens. We describe a case of a 66-year-old man with a history of chronic kidney disease (baseline Cr?=?3–4?mg/dl) and recurrent nephrolithiasis with bilateral stents who had positive concurrent urine and blood cultures for MDR Pseudomonas aeruginosa (PSA), susceptible only to amikacin and colistin. Due to the MDR phenotype and his underlying kidney disease, the 375?mg (250?mg/125?mg) dose of C/T was given as monotherapy every 8?h for his bloodstream infection. Methods Once steady state was anticipated, blood was obtained at the end of infusion (1?h), and at 3, 5 and 8?h for drug concentration determination using a validated high-performance liquid chromatography method at the Center for Anti-Infective Research and Development, Hartford Hospital, Hartford. Results The minimum inhibitory concentration (MIC) for the PSA was 2/4 for C/T, indicating susceptibility. Concentration of ceftolozane of 21.87?μg/ml at 8?h indicated that serum concentrations were maintained above the MIC throughout the dosing interval. The patient was given 25?days of C/T and experienced a successful clinical outcome. Blood cultures obtained at 1 and 3?weeks after completion of treatment remained sterile. No adverse events were attributed to C/T. Conclusion In this patient, the renally adjusted dose of C/T was safe and provided sufficiently high drug concentrations that exceeded the MIC of the infecting organism over the course of therapy. More data are required to determine the clinical utility of C/T in the setting of MDR PSA bacteremia.
机译：前言头孢洛赞/他唑巴坦（C / T）是一种新型抗生素，已被批准用于由革兰氏阳性和革兰氏阴性生物（包括某些MDR菌株）引起的复杂的腹内和尿路感染。关于该剂用于治疗菌血症的用途知之甚少，对于肾脏确定的治疗方案的适用性知之甚少。我们描述了一个有慢性肾脏病病史（基线Cr？=？3？4？mg / dl）和双肾支架复发性肾结石的慢性肾病病史的患者，该患者的MDR假单胞菌同时尿液和血培养呈阳性铜绿假单胞菌（PSA），仅对丁胺卡那霉素和粘菌素敏感。由于MDR表型及其潜在的肾脏疾病，每8小时将375？mg（250？mg / 125？mg）剂量的C / T作为单一疗法给予他的血液感染。方法一旦达到稳态，在输注结束后（1？h），3、5和8？h取血，并在抗感染中心使用经过验证的高效液相色谱法测定药物浓度哈特福德哈特福德医院研究与开发。结果PSA的最低抑制浓度（MIC）为C / T的2/4，表明易感性。头孢唑烷在8？h浓度为21.87？μg/ ml，表明在整个给药间隔中血清浓度均保持在MIC之上。患者接受了25天的C / T治疗，并获得了成功的临床结果。处理完成后第1和3周获得的血液培养物仍保持无菌状态。没有不良事件归因于C / T。结论在该患者中，经肾脏调整的C / T剂量是安全的，并提供足够高的药物浓度，在治疗过程中超过了感染生物的MIC。需要更多数据来确定C / T在MDR PSA菌血症中的临床应用。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号