Salvage Therapy with Ceftolozane-Tazobactam for Multidrug-Resistant Pseudomonas aeruginosa Infections

Abstract

Infections caused by multidrug-resistant Pseudomonas aeruginosa (MDRPA) present a major problem for therapeutic management. We report here our experience with 12 patients with a severe MDRPA infection (6 of which were pneumonia) who received salvage therapy with ceftolozane-tazobactam after inappropriate empirical treatment and/or suboptimal targeted treatment. Although 10 of the 12 patients (83.3%) experienced septic shock, only 3 patients (25%) died during the follow-up period. Microbiological cure in 7 patients (58.3%) was observed.

Ceftolozane/tazobactam for febrile UTI due to multidrug-resistant Pseudomonas aeruginosa in a patient with neurogenic bladder

“…Published clinical data concerning the treatment of infections due to MDR PSA are still rare, and randomized controlled trials are hardly feasible because of their low prevalence. 7 Hence, in a bayesian approach, every experience that could add some evidence of efficient treatment is of interest.…”

Failure of ceftolozane‐tazobactam salvage therapy in complicated pneumonia with lung abscess

“…Notably, these trials are evaluating a higher dose of 3 g IV every 8 hours. Several case reports have also described successful use of ceftolozane‐tazobactam in pneumonia, secondary to multi‐drug resistant P. aeruginosa (MDRPA) 7, 8, 9, 10…”

“…Several case reports have also described successful use of ceftolozane-tazobactam in pneumonia, secondary to multi-drug resistant P. aeruginosa (MDRPA). [7][8][9][10] Failures have been observed with ceftolozane-tazobactam when used off-label. Caston and colleagues studied 6 patients with pneumonia, 2 resulting in deaths and one resulting in a clinical cure but microbiological persistence at 30 days.…”

“…Caston and colleagues studied 6 patients with pneumonia, 2 resulting in deaths and one resulting in a clinical cure but microbiological persistence at 30 days. 8 These patients were confounded by septic shock and multiple medical comorbidities, including one with a lung transplantation. Munita and colleagues studied 18 patients with pneumonia, 7 of whom were considered treatment failures.…”

De nouveaux antibiotiques : oui mais pour quelles situations en réanimation ?

“…Très récemment, une équipe espagnole a rapporté des résultats intéressants sur 12 malades ayant reçu cette association en traitement de sauvetage pour une infection à P. aeruginosa résistante à toutes les autres β-lactamines et à la ciprofloxacine (dont une moitié de pneumonies). Huit des 12 patients ont guéri sans rechute mais dans deux cas, une souche résistante a émergé [4].…”