Machuca Isabel, Dominguez Arantxa, Amaya Rosario, Arjona Cristina, Gracia-Ahufinger Irene, Carralon Maravillas, Giron Rosa, Gea Isabel, De Benito Natividad, Martin Andres, Galan Fatima, Martinez Jose Antonio, Iglesias Rayden, Revuelto Jaume, Caston Juan Jose, Cano Angela, Ruiz-Arabi Elisa, Martínez-Martínez Luis, Torre-Cisneros Julian
Infectious Diseases Service, Hospital Universitario Reina Sofía, Córdoba, Spain.
Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.
Infect Dis Ther. 2025 Jan;14(1):283-292. doi: 10.1007/s40121-024-01077-z. Epub 2024 Nov 29.
Difficult-to-treat-resistant (DTR) infections caused by Pseudomonas aeruginosa represent a global public health threat, prioritizing the search and development of new antibiotics for this microorganism.
We present the real-life experience of the compassionate use of imipenem/cilastatin/relebactam in a descriptive study involving 14 patients with DTR-P. aeruginosa infection and limited treatment options.
The primary source of infection was skin and soft tissue infection, 57.1% (8/14), followed by respiratory infection-pneumonia, 28.6% (4/14). At the onset of infection, 71.4% (10/14) of patients were in the intensive care unit (ICU). All our patients had a Charlson Score of ≥ 3. Septic shock was observed in 64.3% (9/14) of patients. The median treatment duration was 15 days, and no patient experienced an adverse event that required treatment interruption. All-cause 30-day mortality was observed in 42.9% of cases (6/14), while clinical efficacy and microbiological success were observed in 64.3% (9/14).
Imipenem/cilastatin/relebactam may represent a treatment option for patients with DTR-P. aeruginosa infections, which should be validated in prospective clinical trials.
铜绿假单胞菌引起的难治性耐药(DTR)感染是全球公共卫生威胁,因此寻找和开发针对该微生物的新型抗生素至关重要。
我们在一项描述性研究中介绍了亚胺培南/西司他丁/瑞来巴坦同情用药的实际经验,该研究纳入了14例患有DTR-铜绿假单胞菌感染且治疗选择有限的患者。
主要感染源是皮肤和软组织感染,占57.1%(8/14),其次是呼吸道感染-肺炎,占28.6%(4/14)。感染发生时,71.4%(10/14)的患者在重症监护病房(ICU)。所有患者的查尔森评分均≥3。64.3%(9/14)的患者出现感染性休克。中位治疗持续时间为15天,没有患者经历需要中断治疗的不良事件。42.9%(6/14)的病例观察到30天全因死亡率,而64.3%(9/14)观察到临床疗效和微生物学成功。
亚胺培南/西司他丁/瑞来巴坦可能是DTR-铜绿假单胞菌感染患者的一种治疗选择,这应在前瞻性临床试验中得到验证。