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Reminder of important clinical lesson
CASE REPORT
Treatment of a complex orthopaedic infection due to extensively drug-resistant Pseudomonas aeruginosa
  1. Sidra Hassan1,
  2. Mani D Kahn2,
  3. Nidhi Saraiya3,
  4. Priya Nori4
  1. 1Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
  2. 2Department of Orthopedic Surgery, Montefiore Medical Center, Bronx, New York, USA
  3. 3Department of Pharmacy, Montefiore Wakefield Campus, Bronx, New York, USA
  4. 4Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
  1. Correspondence to Dr Sidra Hassan, hassans7{at}nychhc.org

Summary

According to the Centers for Disease Control and Prevention (CDC), approximately 51 000 healthcare-associated infections caused by Pseudomonas aeruginosa occur annually in the USA, more than 6000 of which (13%) are caused by multidrug resistant (MDR) strains. Ceftolozane/tazobactam (TOL/TAZ) (Zerbaxa) was approved by the US Food and Drug Administration (FDA) in December 2014 for the treatment of complicated intra-abdominal and urinary tract infections. At this time, clinical data on the role of TOL/TAZ treatment outside of FDA-approved indications is limited. Herein, we present a case of extensively drug-resistant (XDR) P. aeruginosa osteomyelitis of the upper extremity, which was successfully treated with TOL/TAZ for 8 weeks with optimal clinical and laboratory responses. Monotherapy with TOL/TAZ appears effective for treatment of complicated bone and joint infections with XDR P. aeruginosa in combination with comprehensive surgical management, particularly when few antibiotic options exist.

  • infections
  • musculoskeletal and joint disorders
  • skin
  • drugs: infectious diseases

https://doi.org/10.1136/bcr-2017-223202

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    Footnotes

    • Contributors SH: acquisition of data, drafting, editing, revising and finalising the article. MDK and NS: revising it critically for important intellectual content. PN: conception, design, revision of the article for important intellectual content and final approval of the version to be published. All authors read and approved the final manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.