Maniara Bejoy P, Wells Ian
Present Address: Department of Pharmacy, Kingsbrook Jewish Medical Center, 585 Schenectady Ave, Brooklyn, NY 11203 USA.
SN Compr Clin Med. 2021;3(2):701-704. doi: 10.1007/s42399-021-00750-5. Epub 2021 Jan 21.
Ceftolozane/tazobactam is an intravenous beta-lactam/beta-lactamase inhibitor that utilizes a novel oxyimino-cephalosporin with a traditional beta-lactamase inhibitor. It is approved by the Food and Drug Administration to treat complicated intra-abdominal infections in combination with metronidazole, complicated urinary tract infections, and, most recently, hospital-acquired bacterial and ventilator-associated bacterial pneumonias. It is commonly utilized to treat infections caused by multidrug-resistant . This case report delineates the first published case of ceftolozane/tazobactam-induced leukocytosis (up to 36.9 × 10 cells/L) and clinical failure when utilized in a high-dose regimen for a patient being treated for ventilator-associated pneumonia secondary to carbapenem-resistant . The reaction occurred during initial challenge, resolved after discontinuation, and recurred during re-challenge. In patients who are appropriately being treated with ceftolozane/tazobactam for susceptible infections, consider a drug-induced reaction as a potential cause of rising leukocytosis; this should be differentiated from clinical failure if the patient is clinically stable.
头孢他啶/他唑巴坦是一种静脉注射用β-内酰胺类/β-内酰胺酶抑制剂，它将一种新型氧亚氨基头孢菌素与传统的β-内酰胺酶抑制剂结合使用。它已获美国食品药品监督管理局批准，可与甲硝唑联合用于治疗复杂性腹腔内感染、复杂性尿路感染，以及最近获批用于治疗医院获得性细菌性肺炎和呼吸机相关性细菌性肺炎。它通常用于治疗由多重耐药菌引起的感染。本病例报告描述了首例发表的头孢他啶/他唑巴坦引起白细胞增多（高达36.9×10⁹细胞/L）的病例，以及在一名因耐碳青霉烯类菌引起的呼吸机相关性肺炎患者中采用高剂量方案治疗时出现临床治疗失败的情况。该反应在初始用药时出现，停药后缓解，并在再次用药时复发。对于因易感感染而接受头孢他啶/他唑巴坦适当治疗的患者，应考虑药物诱导反应是白细胞增多的潜在原因；如果患者临床稳定，应将其与临床治疗失败相鉴别。
