Ceftazidime-Avibactam as Osteomyelitis Therapy: A Miniseries and Review of the Literature
Alessandro Mancuso,
Luca Pipitò,
Raffaella Rubino,
Salvatore Antonino Distefano,
Donatella Mangione,
Antonio Cascio
Affiliations
Alessandro Mancuso
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D′Alessandro”, University of Palermo, 90127 Palermo, Italy
Luca Pipitò
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D′Alessandro”, University of Palermo, 90127 Palermo, Italy
Raffaella Rubino
Infectious and Tropical Disease Unit, Sicilian Regional Reference Centre for the Fight against AIDS, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
Salvatore Antonino Distefano
Microbiology and Virology Unit, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
Donatella Mangione
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D′Alessandro”, University of Palermo, 90127 Palermo, Italy
Antonio Cascio
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D′Alessandro”, University of Palermo, 90127 Palermo, Italy
Bone and joint infections (BJIs) caused by multidrug-resistant gram-negative bacteria are becoming a concern due to limited therapeutic options. Although not approved for these indications, an ever-growing amount of evidence supports the efficacy and safety of ceftazidime–avibactam as a therapy for osteomyelitis and prosthetic joint infections. Here, we present three cases of difficult-to-treat resistant Pseudomonas aeruginosa osteomyelitis that were successfully treated with ceftazidime–avibactam alone or in combination therapy with fosfomycin and amikacin. Ceftazidime–avibactam was prescribed at a daily dose of 2.5 g every 8 h for 42 days in all cases. One potential drug-related adverse effect was observed, i.e., Clostridioides difficile infection, which occurred after fourteen days of treatment with ceftazidime–avibactam.
