Successful Treatment of Bacteremia and Ventilator-Associated Pneumonia Caused by KPC/OXA-48-like <i>Klebsiella pneumoniae</i> Co-Producer with a Continuous Infusion of High-Dose Meropenem Plus Fosfomycin Guided by Real-Time Therapeutic Drug Monitoring

Pier Giorgio Cojutti; Giacomo Fornaro; Milo Gatti; Matteo Rinaldi; Paolo Gaibani; Maddalena Giannella; Federico Pea; Pierluigi Viale

doi:10.3390/idr14010010

Infectious Disease Reports (Jan 2022)

Successful Treatment of Bacteremia and Ventilator-Associated Pneumonia Caused by KPC/OXA-48-like <i>Klebsiella pneumoniae</i> Co-Producer with a Continuous Infusion of High-Dose Meropenem Plus Fosfomycin Guided by Real-Time Therapeutic Drug Monitoring

Pier Giorgio Cojutti,
Giacomo Fornaro,
Milo Gatti,
Matteo Rinaldi,
Paolo Gaibani,
Maddalena Giannella,
Federico Pea,
Pierluigi Viale

Affiliations

Pier Giorgio Cojutti: SSD Clinical Pharmacology, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
Giacomo Fornaro: Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
Milo Gatti: SSD Clinical Pharmacology, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
Matteo Rinaldi: Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
Paolo Gaibani: Division of Microbiology, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
Maddalena Giannella: Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
Federico Pea: SSD Clinical Pharmacology, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
Pierluigi Viale: Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy

DOI: https://doi.org/10.3390/idr14010010
Journal volume & issue: Vol. 14, no. 1
pp. 88 – 92

Abstract

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Bacteremia and ventilator-associated pneumonia due to a pan-resistant Klebsiella pneumoniae strain co-producing KPC and OXA-48 carbapenemases was successfully treated in a COVID-19 critically ill patient with a combination therapy of a high-dose continuous infusion of meropenem (up to 3 g every 6 h, daily) plus fosfomycin (up to 24 g/daily) that was guided by real-time therapeutic drug monitoring. Clinical pharmacological advice was helpful in maximizing, over time, the pharmacodynamic target attainment of both antibiotics.

Published in Infectious Disease Reports

ISSN: 2036-7430 (Print); 2036-7449 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine: Other systems of medicine
Website: https://www.mdpi.com/journal/idr

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