Ceftazidime/Avibactam for Treatment of Pleural Empyema Due to Carbapenem-Resistant Serratia marcescens

摘要

To the Editor: Ceftazidime/avibactam (C/A) has recently been approved in the United States for the treatment of complicated urinary tract infections and, in combination with metronidazole, for intra-abdominal infections. Avibactam is a non-beta-lactam beta-lactamase inhibitor with activity against Ambler class A, class C, and some class D serine beta-lactamases. Because of this unique enzyme inhibitor, C/A is felt to be the first (i-lactam/beta-lactamase inhibitor combination with a potential role in the treatment of infections due to carbapenem-resistant Enterobacteriaceae, which produce Klebsiella pneumoniae carbapenemase, the most common carbapenemase in the United States, but not against Enterobacteriaceae that produce metallo-beta-lactamases. With limited therapeutic options, we recently used C/A in the successful treatment of patient with a pleural empyema due to carbapenem-resistant Serratia marcescens. A 60-year-old woman was admitted for treatment of worsening chronic inflammatory demyelinating polyneuropathy with intravenous (IV) immuno-globulin and plasmapheresis. Her course was complicated by respiratory failure and a ventilator-associated pneumonia.