Journal of global antimicrobial resistance · 2025
Successful use of cefepime/zidebactam in deep-seated infections due to extensively drug-resistant Pseudomonas aeruginosa: A case series.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shah Pooja, Neeravi Ayyanraj, Karthik Rajiv, Mathew Christy Merin, Hephzibah Julie, Johnson Hanna Elizabeth, Veeraraghavan Balaji, Manesh Abi
Аннотация
OBJECTIVE: There is a paucity of safe and effective treatment options for extensively drug resistant (XDR) Gram-negative pathogens that often harbor varied resistance mechanisms concurrently. Cefepime/zidebactam (FEP/ZID) is a novel β-lactam/β-lactam enhancer (BL-BLE) combination, currently in Phase 3 trials, that has been shown to be effective against such difficult to treat resistant isolates in-vitro studies and scattered case reports. We present a series of deep seated infections due to XDR Pseudomonas Aeruginosa (PsA), successfully treated with FEP/ZID under compassionate use.
METHODS: Between September 2023 and May 2024, using clinico-radiographic and microbiologic (phenotypic drug susceptibility and whole genome sequencing) data, we identified five XDR PsA related infections that could not be safely treated with currently available antibiotics. All patients received FEP/ZID after obtaining informed consent and necessary approvals.
RESULTS: Four cases involved osteoarticular disease while the fifth was an endovascular graft infection. Clinical specimens yielded XDR PsA isolates that harbored varied (enzymatic and non-enzymatic) resistance mechanisms to anti-pseudomonal cephalosporins, carbapenems, aminoglycosides, fluoroquinolones and newer β-lactam/β-lactamase inhibitors. All isolates were susceptible to FEP/ZID and were treated with the same for 2-6 wk. Clinico-radiographic assessments confirmed significant resolution of lesions in all cases. There were with no drug-related adverse events.
CONCLUSIONS: The in-vitro susceptibility of our XDR PsA isolates to FEP/ZID translated to a successful clinical outcome in our series of deep-seated infections. FEP/ZID is a potential safe and effective treatment option for such serious Gram-negative infections.
METHODS: Between September 2023 and May 2024, using clinico-radiographic and microbiologic (phenotypic drug susceptibility and whole genome sequencing) data, we identified five XDR PsA related infections that could not be safely treated with currently available antibiotics. All patients received FEP/ZID after obtaining informed consent and necessary approvals.
RESULTS: Four cases involved osteoarticular disease while the fifth was an endovascular graft infection. Clinical specimens yielded XDR PsA isolates that harbored varied (enzymatic and non-enzymatic) resistance mechanisms to anti-pseudomonal cephalosporins, carbapenems, aminoglycosides, fluoroquinolones and newer β-lactam/β-lactamase inhibitors. All isolates were susceptible to FEP/ZID and were treated with the same for 2-6 wk. Clinico-radiographic assessments confirmed significant resolution of lesions in all cases. There were with no drug-related adverse events.
CONCLUSIONS: The in-vitro susceptibility of our XDR PsA isolates to FEP/ZID translated to a successful clinical outcome in our series of deep-seated infections. FEP/ZID is a potential safe and effective treatment option for such serious Gram-negative infections.