Ceftazidime-avibactam and intrapleural amikacin therapy for extensively drug-resistant Pseudomonas aeruginosa thoracic empyema
Abstract. Introduction:. Thoracic empyema and concomitant bronchopleural fistula are serious complications of pneumonia. The treatment of empyema caused by extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has become increasingly challenging. Patient's concerns and important clinical f...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-06-01
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| Series: | Medicine |
| Online Access: | http://journals.lww.com/10.1097/MD.0000000000029467 |
| _version_ | 1811236823238705152 |
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| author | Tzu-Ting Chen, MS Shu-Mei Chen, MD Hsin-Yi Liu, MD |
| author_facet | Tzu-Ting Chen, MS Shu-Mei Chen, MD Hsin-Yi Liu, MD |
| author_sort | Tzu-Ting Chen, MS |
| collection | DOAJ |
| description | Abstract. Introduction:. Thoracic empyema and concomitant bronchopleural fistula are serious complications of pneumonia. The treatment of empyema caused by extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has become increasingly challenging.
Patient's concerns and important clinical findings:. A 57-year-old woman with controlled schizophrenia developed hospital-associated bacterial pneumonia secondary to P. aeruginosa on day 13 of hospitalization for brain meningioma surgery.
Diagnosis:. Chest radiography and computed tomography revealed right-sided necrotizing pneumonia with pneumothorax, a focal soft tissue defect over the right lower chest wall, and a mild right-sided encapsulated pleural effusion with consolidation. XDR-PA was isolated on empyema cultures.
Interventions:. The patient was treated with intrapleural amikacin as a bridge to video-assisted thoracoscopic surgery, followed by novel ceftazidime-avibactam therapy.
Outcomes:. On the 104th day of admission, the patient underwent chest wall debridement and closure. The patient was discharged on day 111. Twenty-eight days after discharge, there were no observable sequelae of empyema.
Conclusion:. Although the minimum inhibitory concentration of ceftazidime-avibactam for XDR-PA is relatively high (8 mg/L), this report emphasizes the efficacy of ceftazidime-avibactam treatment for XDR-PA empyema, as well as the importance of source control. |
| first_indexed | 2024-04-12T12:14:46Z |
| format | Article |
| id | doaj.art-903c9132108945c9b5d47238e08a71c4 |
| institution | Directory Open Access Journal |
| issn | 0025-7974 1536-5964 |
| language | English |
| last_indexed | 2024-04-12T12:14:46Z |
| publishDate | 2022-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Medicine |
| spelling | doaj.art-903c9132108945c9b5d47238e08a71c42022-12-22T03:33:27ZengWolters KluwerMedicine0025-79741536-59642022-06-0110124e2946710.1097/MD.0000000000029467202206170-00041Ceftazidime-avibactam and intrapleural amikacin therapy for extensively drug-resistant Pseudomonas aeruginosa thoracic empyemaTzu-Ting Chen, MSShu-Mei Chen, MDHsin-Yi Liu, MDAbstract. Introduction:. Thoracic empyema and concomitant bronchopleural fistula are serious complications of pneumonia. The treatment of empyema caused by extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has become increasingly challenging. Patient's concerns and important clinical findings:. A 57-year-old woman with controlled schizophrenia developed hospital-associated bacterial pneumonia secondary to P. aeruginosa on day 13 of hospitalization for brain meningioma surgery. Diagnosis:. Chest radiography and computed tomography revealed right-sided necrotizing pneumonia with pneumothorax, a focal soft tissue defect over the right lower chest wall, and a mild right-sided encapsulated pleural effusion with consolidation. XDR-PA was isolated on empyema cultures. Interventions:. The patient was treated with intrapleural amikacin as a bridge to video-assisted thoracoscopic surgery, followed by novel ceftazidime-avibactam therapy. Outcomes:. On the 104th day of admission, the patient underwent chest wall debridement and closure. The patient was discharged on day 111. Twenty-eight days after discharge, there were no observable sequelae of empyema. Conclusion:. Although the minimum inhibitory concentration of ceftazidime-avibactam for XDR-PA is relatively high (8 mg/L), this report emphasizes the efficacy of ceftazidime-avibactam treatment for XDR-PA empyema, as well as the importance of source control.http://journals.lww.com/10.1097/MD.0000000000029467 |
| spellingShingle | Tzu-Ting Chen, MS Shu-Mei Chen, MD Hsin-Yi Liu, MD Ceftazidime-avibactam and intrapleural amikacin therapy for extensively drug-resistant Pseudomonas aeruginosa thoracic empyema Medicine |
| title | Ceftazidime-avibactam and intrapleural amikacin therapy for extensively drug-resistant Pseudomonas aeruginosa thoracic empyema |
| title_full | Ceftazidime-avibactam and intrapleural amikacin therapy for extensively drug-resistant Pseudomonas aeruginosa thoracic empyema |
| title_fullStr | Ceftazidime-avibactam and intrapleural amikacin therapy for extensively drug-resistant Pseudomonas aeruginosa thoracic empyema |
| title_full_unstemmed | Ceftazidime-avibactam and intrapleural amikacin therapy for extensively drug-resistant Pseudomonas aeruginosa thoracic empyema |
| title_short | Ceftazidime-avibactam and intrapleural amikacin therapy for extensively drug-resistant Pseudomonas aeruginosa thoracic empyema |
| title_sort | ceftazidime avibactam and intrapleural amikacin therapy for extensively drug resistant pseudomonas aeruginosa thoracic empyema |
| url | http://journals.lww.com/10.1097/MD.0000000000029467 |
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