Zikri Ahmed, El Masri Kamal
Ahmed Zikri, Department of Pharmacy, King Fahad Specialist Hospital, Dammam 31444, Saudi Arabia.
Antibiotics (Basel). 2019 May 27;8(2):67. doi: 10.3390/antibiotics8020067.
Infections, with multidrug-resistant a, are a major concern in the pediatric intensive care unit, especially in immunocompromised patients. Some of these strains are resistant to all beta-lactams, including carbapenems, leaving very limited treatment options remaining. These options include aminoglycosides and colistin, both of which have poor pharmacokinetic profiles with significant toxicities. Newer beta-lactam/beta-lactamase inhibitor combinations offer additional novel options to treat such infections, given their good pharmacokinetic profiles and activity against multi-drug resistant strains. Ceftolozane/tazobactam is a novel cephalosporin/beta-lactamase inhibitor combination approved in 2014. The drug demonstrates good activity against multidrug-resistant strains, including those resistant to all other antibiotics. Ceftolozane/tazobactam is currently approved in adult patients 18 years and older only. There are very limited data on its pharmacokinetic profile and clinical utility in the pediatric population. We report the use of ceftolozane/tazobactam to successfully treat pneumonia caused by multidrug-resistant in a pediatric patient with combined immunodeficiency syndrome.
多重耐药菌感染是儿科重症监护病房的一个主要问题，尤其是在免疫功能低下的患者中。其中一些菌株对所有β-内酰胺类药物耐药，包括碳青霉烯类，使得剩下的治疗选择非常有限。这些选择包括氨基糖苷类和黏菌素，这两种药物的药代动力学特性都很差，且毒性很大。新型β-内酰胺/β-内酰胺酶抑制剂组合因其良好的药代动力学特性和对多重耐药菌株的活性，为治疗此类感染提供了更多新的选择。头孢洛扎/他唑巴坦是2014年获批的一种新型头孢菌素/β-内酰胺酶抑制剂组合。该药物对多重耐药菌株表现出良好的活性，包括那些对所有其他抗生素耐药的菌株。头孢洛扎/他唑巴坦目前仅被批准用于18岁及以上的成年患者。关于其在儿科人群中的药代动力学特性和临床效用的数据非常有限。我们报告了使用头孢洛扎/他唑巴坦成功治疗一名患有联合免疫缺陷综合征的儿科患者由多重耐药菌引起的肺炎。
