Journal
INFECTION AND DRUG RESISTANCE
Volume 14, Issue -, Pages 1691-1701Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/IDR.S306222
Keywords
ceftazidime-avibactam; extensively drug-resistant Gram-negative bacillus; Klebsiella pneumoniae; Pseudomonas aeruginosa; ventriculitis infection
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Funding
- National Natural Science Foundation of China [81971159, 81470052]
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Ceftazidime/avibactam has shown efficacy in treating central nervous system infections caused by multidrug-resistant or extensively drug-resistant Gram-negative bacteria. Three patients with MDR/XDR-associated CNS infections were effectively treated with intravenously administered ceftazidime/avibactam in combination with another antibiotic.
Background: Central nervous system (CNS) infections caused by multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative bacillus, including carbapenem-resistant Enterobacteriaceae (CRE) and Pseudomonas aeruginosa, are associated with high mortality rates. Clinical trials of ceftazidime/avibactam (CAZ/AVI) on infections of other systems indicate that they are effective against these infections. However, clinical studies on the efficacies of CAZ/AVI in the treatment of CNS infections have not been done. Case Presentation: We evaluated 3 patients diagnosed with MDR/XDR Gram-negative bacillus-associated CNS infections, and effectively treated with CAZ/AVI. Moreover, we performed literature reviews. Before the onset of CNS infections, the 3 patients were subjected to neurosurgical operations, treated with mechanical ventilation, long-term intensive care unit therapy, and various antibiotics. By intravenously administering CAZ/AVI, combined with another antibiotic, the MDR/XDR K. pneumoniae and P. aeruginosa associated ventriculitis was effectively treated in the 3 patients. Conclusion: CAZ/AVI is a viable treatment option for CNS infections caused by MDR/XDR Gram-negative bacteria.
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