The use of therapeutic drug monitoring to optimize treatment of carbapenem-resistant enterobacter osteomyelitis

Stewart, Adam, Graves, Bianca, Hajkowicz, Krispin, Ta, Kim and Paterson, David L. (2015) The use of therapeutic drug monitoring to optimize treatment of carbapenem-resistant enterobacter osteomyelitis. Microbial Drug Resistance, 21 6: 631-635. doi:10.1089/mdr.2015.0006


Author Stewart, Adam
Graves, Bianca
Hajkowicz, Krispin
Ta, Kim
Paterson, David L.
Title The use of therapeutic drug monitoring to optimize treatment of carbapenem-resistant enterobacter osteomyelitis
Journal name Microbial Drug Resistance   Check publisher's open access policy
ISSN 1931-8448
1076-6294
Publication date 2015-12-01
Year available 2015
Sub-type Article (original research)
DOI 10.1089/mdr.2015.0006
Open Access Status Not yet assessed
Volume 21
Issue 6
Start page 631
End page 635
Total pages 5
Place of publication New Rochelle, NY, United States
Publisher Mary Ann Liebert Inc.
Language eng
Formatted abstract
Introduction: Invasive infections due to carbapenem-resistant Enterobacteriaceae (CRE) are becoming increasingly more prevalent and provide significant morbidity and mortality. Providing curative therapy and overcoming bacterial resistance are difficult tasks with limited antibiotic options. Alternative antibiotics and approaches to therapy are required, with often a compromise in patient outcome.

Aim: To demonstrate the effective use of therapeutic drug monitoring (TDM) in difficult-to-treat infections due to multiresistant gram-negative bacteria.

Case Presentation:
A case of an elderly woman with an invasive cervical spine infection due to CRE is presented. Her protracted therapeutic course was complicated by multiple treatment failures and severe cervical spine instability. Therapeutic success, as determined by wound healing, cervical spine stability, and continued suppression of inflammatory markers, was obtained by continuous daily ertapenem infusions with TDM guiding the optimal drug dosing.

Conclusion: In this unusual setting, TDM was utilized successfully to achieve favorable serum antibiotic concentrations and lead to control of the infection. TDM may be a useful tool in difficult-to-treat infections caused by multiresistant bacteria.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2016 Collection
 
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