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2017 ; 3
(ä): 17019
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Ceftolozane/tazobactam for febrile UTI due to multidrug-resistant Pseudomonas
aeruginosa in a patient with neurogenic bladder
#MMPMID28503325
Dinh A
; Davido B
; Calin R
; Paquereau J
; Duran C
; Bouchand F
; Phé V
; Chartier-Kastler E
; Rottman M
; Salomon J
; Plésiat P
; Potron A
Spinal Cord Ser Cases
2017[]; 3
(ä): 17019
PMID28503325
show ga
INTRODUCTION: Urinary tract infections (UTI) are a major public health problem
among spinal cord injury (SCI) patients. They frequently involve
multidrug-resistant (MDR) bacteria. Ceftolozane/tazobactam (C/T) is a novel
antibiotic combination approved for complicated intra-abdominal and UTI caused by
Gram-positive and Gram-negative organisms, including some MDR strains. Little is
known about the use of this agent for complicated febrile UTI occurring among SCI
patients with neurogenic bladder due to MDR Pseudomonas aeruginosa (PSA). CASE
PRESENTATION: We describe the case of a 35-year-old man with SCI due to multiple
sclerosis, with a neurogenic bladder necessitating a bilateral nephrostomy and
double J catheter, who developed a febrile UTI due to a MDR PSA, which was
susceptible only to amikacin and colistin. Because of this MDR phenotype and the
underlying kidney disease, a 1000?mg (1000?mg per 500?mg) dose of C/T was given
as monotherapy every 8?h for 7 days, after 3 days of colistin and amikacin.
Thanks to this treatment, the patient had a favorable outcome with no clinical
signs of UTI or positive urine culture up to 1 month after diagnosis. DISCUSSION:
C/T seems to be an effective and safe therapeutic option for febrile UTI due to
MDR PSA in SCI patients with neurogenic bladder, even when administered in
monotherapy for 10 days.
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