Successful Treatment of Bacteremia and Ventilator-Associated Pneumonia Caused by KPC/OXA-48-like Klebsiella pneumoniae Co-Producer with a Continuous Infusion of High-Dose Meropenem Plus Fosfomycin Guided by Real-Time Therapeutic Drug Monitoring.
Pier Giorgio CojuttiGiacomo FornaroMilo GattiMatteo RinaldiPaolo GaibaniMaddalena GiannellaFederico PeaPierluigi VialePublished in: Infectious disease reports (2022)
Bacteremia and ventilator-associated pneumonia due to a pan-resistant Klebsiella pneumoniae strain co-producing KPC and OXA-48 carbapenemases was successfully treated in a COVID-19 critically ill patient with a combination therapy of a high-dose continuous infusion of meropenem (up to 3 g every 6 h, daily) plus fosfomycin (up to 24 g/daily) that was guided by real-time therapeutic drug monitoring. Clinical pharmacological advice was helpful in maximizing, over time, the pharmacodynamic target attainment of both antibiotics.
Keyphrases
- klebsiella pneumoniae
- gram negative
- multidrug resistant
- high dose
- combination therapy
- low dose
- acinetobacter baumannii
- drug resistant
- stem cell transplantation
- coronavirus disease
- sars cov
- physical activity
- escherichia coli
- case report
- respiratory failure
- intensive care unit
- cystic fibrosis
- respiratory syndrome coronavirus
- mechanical ventilation