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Efficacy and safety of ceftolozane/tazobactam as therapeutic option for complicated skin and soft tissue infections by MDR/XDR Pseudomonas aeruginosa in patients with impaired renal function: a case series from a single-center experience

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Abstract

Introduction

Pseudomonas aeruginosa (PA) is a known cause of skin and soft tissue infections (SSTIs). Therapeutic options against multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of PA are limited, especially in patients with impaired renal function. Ceftolozane/tazobactam (C/T) is a novel beta-lactam/beta-lactamase inhibitor with powerful anti-PA activity. Thanks to its characteristics, it appears to be the best available anti-pseudomonal drug in many clinical scenarios. A case series of four adult patients followed between January 2018 and May 2019 is reported. All subjects presented complicated SSTIs by MDR- or XDR-PA and were affected by chronic kidney disease.

Results

C/T was used as a monotherapy in three cases and in combination regimen in the remaining case. In two cases, C/T was the first-line option, in the remaining ones was the salvage treatment. All patients were successfully treated without worsening of renal function and without any other adverse events.

Conclusions

C/T may represent a useful option against MDR- and XDR-PA strains responsible of complicated SSTIs in patients affected by impaired renal function.

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Funding

No funds were received for this study.

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Authors and Affiliations

  1. Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples “Federico II”, Naples, Italy

    A. R. Buonomo, A. E. Maraolo, R. Scotto, M. Foggia, E. Zappulo, P. Congera, S. Parente & I. Gentile

Authors
  1. A. R. Buonomo
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  2. A. E. Maraolo
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  3. R. Scotto
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  4. M. Foggia
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  5. E. Zappulo
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  6. P. Congera
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  7. S. Parente
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  8. I. Gentile
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Corresponding author

Correspondence to A. E. Maraolo.

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Conflict of interest

IG acted as a consultant for MSD, Abbvie, Correvio. He managed department grant from Gilead.

Ethical standards

All medical research assessments involving human subjects, including research on identifiable human material and data have been performed according to the Declaration of Helsinki. All patients’ personal data have been anonymized. No ethical approval was required due to the retrospective nature of this study and no patient identifying information was utilized in this publication. At any rate, local authorization for the off-label use of C/T was collected for all the patients according to Italian regulations. Moreover, patients provided written consent to the use for scientific purposes of their anonymized data stemming from routine clinical practice.

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Buonomo, A.R., Maraolo, A.E., Scotto, R. et al. Efficacy and safety of ceftolozane/tazobactam as therapeutic option for complicated skin and soft tissue infections by MDR/XDR Pseudomonas aeruginosa in patients with impaired renal function: a case series from a single-center experience. Infection 48, 303–307 (2020). https://doi.org/10.1007/s15010-020-01390-y

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  • DOI: https://doi.org/10.1007/s15010-020-01390-y

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