Off-Label Use of Ceftolozane/Tazobactam for the Successful Treatment of Healthcare-Associated Meningitis Caused by Extensively Drug-Resistant <i>Pseudomonas aeruginosa</i> in a Polytraumatized Patient—A Case Report
Simon Dubler,
Thorsten Brenner,
Stefan Zimmermann,
Theresa Mokry,
Anka Röhr,
Daniel C. Richter,
Alexandra Heininger,
Markus A. Weigand
Affiliations
Simon Dubler
Department of Anaesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany
Thorsten Brenner
Department of Anaesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany
Stefan Zimmermann
Department of Infectious Diseases, Medical Microbiology and Hygiene, Division Bacteriology, Heidelberg University Hospital, D-69120 Heidelberg, Germany
Theresa Mokry
Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany
Anka Röhr
Department of Clinical Pharmacy, Heidenheim Hospital, Schloßhaustraße 100, D-89522 Heidenheim, Germany
Daniel C. Richter
Department of Anaesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany
Alexandra Heininger
Unit of Hospital Hygiene, Mannheim University Hospital, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany
Markus A. Weigand
Department of Anaesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany
Background: Hospital-acquired infections with extensively drug-resistant (XDR) Pseudomonas aeruginosa (PA) have become a worrisome concern because of unfavorable outcomes and limited antimicrobial treatment options. Studies with new antimicrobial substances against XDR-PA show very promising results in different infection types, but the data for central nervous system (CNS) infections are scarce. Case presentation: Here, we report the case of a young patient with healthcare-associated meningitis caused by XDR-PA following severe craniocerebral injury. An off-label use of high-dose ceftolozane/tazobactam (C/T) monotherapy was administered for 10 days in parallel with source-controlling measures. Clinical and microbial recovery could be accomplished promptly. Conclusion: In patients with hospital-acquired CNS infections due to XDR-PA, C/T might be a new, safe and effective alternative with fewer adverse effects compared to older polymyxin- or aminoglycoside-based regimens.
