Left-sided endocarditis caused by Pseudomonas aeruginosa: successful treatment with meropenem and tobramycin

Gavin, Patrick J.; Suseno, Mira; Cook, Francis V.; Peterson, Lo Ann C.; Thomson, Ruth B.

doi:10.1016/s0732-8893(03)00135-4

Cited by 32 publications

(20 citation statements)

References 18 publications

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“…We currently administer tobramycin as a single daily dose, aiming for a peak level of 18 to 22 μ g/mL and a trough level of less than 1 μ g/mL at 18 hours. For cefepimeresistant strains, treatment consists of imipenem, 3 to 6 g/d [ 39 , 40 ], or meropenem, 3 g/d [ 41 ], with high-dose tobramycin. Tricuspid valve surgery is recommended for right-sided endocarditis if bacteremia persists after 2 weeks of therapy with cefepime plus high-dose aminoglycoside or if bacteremia recurs after cessation of a 6-week course of appropriate antibiotic therapy.…”

Section: Pseudomonas Aeruginosamentioning

confidence: 99%

Gram-negative endocarditis

Reyes

Reyes²

2008

Curr Infect Dis Rep

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Aerobic gram-negative bacilli are rare causes of endocarditis. The epidemiology and risk factors for developing gram-negative endocarditis are evolving. New pathogens, some of which are multidrug resistant, are emerging. The role of nosocomial infections, particularly central venous catheter infections, is increasing. Medical and surgical outcomes appear to be improving with more effective antimicrobial therapy and aggressive surgical management.

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Section: Pseudomonas Aeruginosamentioning

confidence: 99%

Gram-negative endocarditis

Reyes

Reyes²

2008

Curr Infect Dis Rep

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“…This clinical experience, relevant to the current antimicrobial susceptibility pattern of Pseudomonas, achieved a favourable outcome, with an overall medical/surgical cure rate of 90% with cefepime 4-6 g/d for 6 weeks combined with high-dose tobramycin (8 mg/kg per day) [6]. In cefepimeresistant cases, meropenem at 3-6 g/d in association with high-dose tobramycin may be a valuable option [26]. Renal toxicity or prior kidney function impairment may hamper aminoglycoside treatment.…”

Section: Non-fermenting Bacillimentioning

confidence: 83%

Management of Gram-negative and fungal endocarditis

Durante‐Mangoni

Tripodi

Albisinni

et al. 2010

International Journal of Antimicrobial Agents

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Infective endocarditis is infrequently caused by Gram-negative bacteria or fungi.Gram-negative organisms are responsible for <4% of cases, while fungal endocarditis accounts for <1.5% of culture-positive cases worldwide. Endocarditis due to Gram-negative organisms or fungi is a rare but severe disease. It often has a nosocomial origin, is caused by virulent and often resistant organisms and presents a high rate of complications and high mortality. In this article we present the most recent literature data and address the current management of Gram-negative and fungal infective endocarditis. We also discuss the major challenges of antimicrobial treatment and discuss some issues related to surgical decision-making in difficult-tomanage cases. We finally present our centre's experience with Gram-negative infective endocarditis, with a special focus on the demanding issues that the management of these complex and severely ill patients raise.

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“…A combination of antibiotics, typically with antipseudomonal penicillin and an aminoglycoside, is considered a cornerstone of medical therapy; however, different antibiotic combinations or a single antibiotic regimen (e.g. beta-lactam or carbapenem) have also proven successful [2,10]. Our patient was initially treated with a high-dose combination of piperacillintazobactam + amikacin.…”

Section: Discussionmentioning

confidence: 99%

Mitral valve endocarditis caused by Pseudomonas aeruginosa: a case report

Polovina

Potpara

Milošević

et al. 2014

J Infect Dev Ctries

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Previously, endocarditis caused by Pseudomonas aeruginosa mostly involved right-sided valvular infection and generally carried a good prognosis. Recently, changes have been observed in the occurrence and clinical presentation of pseudomonal endocarditis, with increasing incidence of nosocomial infections and involvement of the aortic and mitral valves. Still, pseudomonal left-sided endocarditis is rare, but is frequently associated with complications and high mortality rates. A case of a high-risk patient with coronary artery disease and left-ventricular dysfunction, successfully treated for pseudomonal mitral valve endocarditis complicated by splenic abscess formation, is presented here.

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Left-sided endocarditis caused by Pseudomonas aeruginosa: successful treatment with meropenem and tobramycin

Cited by 32 publications

References 18 publications

Gram-negative endocarditis

Gram-negative endocarditis

Management of Gram-negative and fungal endocarditis

Mitral valve endocarditis caused by Pseudomonas aeruginosa: a case report

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