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Use of Ceftolozane/Tazobactam for the Treatment of Multidrug-Resistant Pseudomonas aeruginosa Pneumonia in a Pediatric Patient with Combined Immunodeficiency (CID): A Case Report from a Tertiary Hospital in Saudi Arabia

机译:头孢洛赞/他唑巴坦在合并免疫缺陷(CID)的小儿患者中治疗多药耐药的铜绿假单胞菌肺炎:沙特阿拉伯一家三级医院的病例报告

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摘要

Infections, with multidrug-resistant Pseudomonas aeruginosa, are a major concern in the pediatric intensive care unit, especially in immunocompromised patients. Some of these strains are resistant to all beta-lactams, including carbapenems, leaving very limited treatment options remaining. These options include aminoglycosides and colistin, both of which have poor pharmacokinetic profiles with significant toxicities. Newer beta-lactam/beta-lactamase inhibitor combinations offer additional novel options to treat such infections, given their good pharmacokinetic profiles and activity against multi-drug resistant strains. Ceftolozane/tazobactam is a novel cephalosporin/beta-lactamase inhibitor combination approved in 2014. The drug demonstrates good activity against multidrug-resistant P. aeruginosa strains, including those resistant to all other antibiotics. Ceftolozane/tazobactam is currently approved in adult patients 18 years and older only. There are very limited data on its pharmacokinetic profile and clinical utility in the pediatric population. We report the use of ceftolozane/tazobactam to successfully treat pneumonia caused by multidrug-resistant P. aeruginosa in a pediatric patient with combined immunodeficiency syndrome.
机译:带有多重耐药性的铜绿假单胞菌感染是小儿重症监护病房的主要关注点,尤其是免疫功能低下的患者。这些菌株中的一些对所有β-内酰胺类(包括碳青霉烯类)都具有抗性,剩下的治疗选择非常有限。这些选择包括氨基糖苷和大粘菌素,它们的药代动力学特征均较差,且具有明显的毒性。鉴于其良好的药代动力学特性和抗多种耐药菌株的活性,较新的β-内酰胺/β-内酰胺酶抑制剂组合为治疗此类感染提供了其他新选择。头孢唑烷/他唑巴坦是2014年批准的新型头孢菌素/β-内酰胺酶抑制剂组合。该药物显示出对多重耐药铜绿假单胞菌菌株(包括对所有其他抗生素具有耐药性的菌株)的良好活性。头孢洛赞/他唑巴坦目前仅在18岁以上的成年患者中得到批准。关于其在儿科人群中的药代动力学特征和临床效用的数据非常有限。我们报告了头孢洛氮/他唑巴坦在合并免疫缺陷综合症的小儿患者中成功治疗多药耐药性铜绿假单胞菌引起的肺炎。

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