A novel combination regimen for the treatment of refractory bacteremia due to multidrug-resistant Pseudomonas aeruginosa in a liver transplant recipient.

Abstract

Both bacteremia and biliary cast syndrome are serious post-transplant complications in liver transplant recipients. In the setting of increasing drug resistance in the current era, management of infections caused by multidrug-resistant (MDR) bacteria has proven challenging. We present a case of a liver transplant recipient who developed biliary cast syndrome and intractable MDR Pseudomonas bacteremia that failed to resolve with conventional antimicrobial therapy and which was finally controlled by a novel combination regimen of colistimethate, doripenem, and tobramycin. Future studies validating the clinical efficacy of this combination strategy are warranted.

• Authors: H-Y Sun, R K Shields, T V Cacciarelli, R R Muder, N Singh
• Journal: Transplant infectious disease : an official journal of the Transplantation Society (Transpl Infect Dis) Vol. 12 Issue 6 Pg. 555-60 (Dec 2010) ISSN: 1399-3062 [Electronic] Denmark
• PMID: 20626709 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2010 John Wiley & Sons A/S.

Chemical References

• Anti-Bacterial Agents
• Carbapenems
• Doripenem
• colistinmethanesulfonic acid
• Tobramycin
• Colistin

Topics

• Anti-Bacterial Agents (pharmacology, therapeutic use)
• Bacteremia (drug therapy, microbiology)
• Bile Duct Diseases (drug therapy, microbiology)
• Carbapenems (therapeutic use)
• Colistin (analogs & derivatives, therapeutic use)
• Doripenem
• Drug Resistance, Multiple, Bacterial
• Drug Therapy, Combination
• Humans
• Liver Transplantation (adverse effects)
• Male
• Microbial Sensitivity Tests
• Middle Aged
• Pseudomonas Infections (drug therapy, microbiology)
• Pseudomonas aeruginosa (drug effects)
• Tobramycin (therapeutic use)
• Treatment Outcome