Infection and Drug Resistance (Aug 2024)
Carrimycin, as One of the Drugs in Combination Therapy, for the Treatment of Carbapenem-Resistant Acinetobacter Baumannii Infection
Abstract
Ning Du,1,* Dan You,2,* Dava Tenzing,3 Dongxiang Qu,2 Jun Meng,1,* Yihui Wang,4,* Juan He5,* 1Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong Province, People’s Republic of China; 2Department of Pharmacy, The First Hospital of Qiqihar, Qiqihar, Heilongjiang Province, People’s Republic of China; 3Department of Emergency, People’s Hospital of Shigatse City, Shigatse, Xizang Autonomous Region, People’s Republic of China; 4Department of Emergency, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 5Department of Pharmacy, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Juan He, Department of Pharmacy, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China, Email [email protected] Yihui Wang, Department of Emergency, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China, Email [email protected]: Infection with carbapenem-resistant Acinetobacter baumannii (CRAB) is a tough nut to crack. Carrimycin is a novel recombinant macrolide antibiotic, and has good anti-infection effects in vivo. At present, it is rarely reported for treatment of CRAB infection. We present a case where a patient with COVID-19 complicated by CRAB infection was successfully treated with a combination therapy including carrimycin, offering clinical insights and experience.Patients and Methods: The patient infected with CRAB was cured by carrimycin combined with tigecycline and amikacin ultimately. We analyzed and summarized the therapeutic regimen and disease feature to provide reference for clinical treatment.Results: The patient was admitted to emergency observation wards with fever and was diagnosed with COVID-19 pneumonia. During the treatment, his condition worsened. He had a fever, cough, and expectoration. After 3 days of empirical treatment with meropenem, tested positive for A. baumannii infection by the next-generation sequencing, and CRAB was detected in blood and sputum culture. Then, he was administered with tigecycline and amikacin immediately for 5 days, however the therapeutic effect was not significant. The patient still remained in a high inflammatory response. Ultimately, the treatment regimen was changed to carrimycin combined with tigecycline and amikacin for 7 days, and then carrimycin combined with tigecycline for 10 days, the patient’s clinical condition gradually improved. The patient received carrimycin monotherapy for 7 days, then discharged.Conclusion: Carrimycin may be a bright alternative for CRAB infection as one of the drugs in combination therapy, especially in a patient with hyperinflammatory response.Keywords: Carrimycin, Carbapenem-resistant Acinetobacter baumannii, CRAB, case report
