Premium
Treatment of Multidrug‐Resistant P seudomonas aeruginosa Using Extended‐Infusion Antimicrobial Regimens
Author(s) -
Heil Emily L.,
Lowery Ashleigh V.,
Thom Kerri A.,
Nicolau David P.
Publication year - 2015
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/phar.1514
Subject(s) - cefepime , pseudomonas aeruginosa , medicine , bacteremia , antimicrobial , antibiotics , multiple drug resistance , intensive care medicine , pharmacodynamics , pharmacokinetics , dosing , pharmacology , antibiotic resistance , microbiology and biotechnology , imipenem , biology , bacteria , genetics
In the management of multidrug‐resistant infections in critically ill patients with multiorgan dysfunction, consideration must be given to the pharmacokinetics and pharmacodynamics of an antimicrobial agent to optimize dosing. We describe a 25‐year‐old woman who was undergoing thrice‐weekly hemodialysis and developed multidrug‐resistant Pseudomonas aeruginosa bacteremia secondary to infected left and right ventricular assist devices. After multiple courses of antibiotics, her blood cultures revealed that the infecting organism was becoming progressively more resistant to antibiotic options. Cefepime 2 g administered over 3 hours/day (in combination with colistimethate) provided adequate drug levels for multidrug‐resistant, cefepime‐intermediate P. aeruginosa bacteremia in this patient. We present the clinical case of this patient, followed by a discussion of possible therapeutic approaches to be considered, including illustration of the principles of using extended‐infusion antimicrobial regimens, and present the patient's resulting clinical course.