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Combining bacteriophages with cefiderocol and meropenem/vaborbactam to treat a pan‐drug resistant Achromobacter species infection in a pediatric cystic fibrosis patient
Author(s) -
Gainey Andrew B.,
Burch AnnaKathryn,
Brownstein Michael J.,
Brown David E.,
Fackler Joseph,
Horne Bri'Anna,
Biswas Biswajit,
Bivens Brittany N.,
Malagon Francisco,
Daniels Robert
Publication year - 2020
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24945
Subject(s) - medicine , achromobacter , cystic fibrosis , pseudomonas aeruginosa , drug resistance , antibiotics , sputum , achromobacter xylosoxidans , meropenem , antibiotic resistance , intensive care medicine , microbiology and biotechnology , biology , pseudomonas , pathology , bacteria , tuberculosis , genetics
Abstract Cystic fibrosis is associated with significant morbidity and early mortality due to recurrent acute and chronic lung infections. The chronic use of multiple antibiotics without pathogen eradication increases the possibility of extensive drug resistance or even pan‐drug resistance (PDR). It is imperative that new or alternative treatment options be explored. We present a clinical case of a 10‐year‐old female cystic fibrosis patient, infected with a PDR Achromobacter spp. She was treated with cefiderocol, meropenem/vaborbactam, and bacteriophage therapy (Ax2CJ45ϕ2) during two separate admissions in an attempt to clear her infection and restore baseline pulmonary function. The Centers for Disease Control and Prevention confirmed antibiotic susceptibilities, which showed resistance to both cefiderocol and meropenem/vaborbactam. However, after using all three agents concomitantly during the second treatment course, our patient's pulmonary function improved dramatically, and the Achromobacter spp. could not be isolated from sputum samples obtained 8 and 16 weeks after completion of therapy. Overall, the treatment regimen consisting of cefiderocol, meropenem/vaborbactam, and bacteriophage was safe and well‐tolerated in our patient.