Continuous infusion of ceftolozane-tazobactam resulted in high cerebrospinal fluid concentrations of ceftolozane in a patient with multidrug-resistant Pseudomonas aeruginosa meningitis

Infection. 2021 Apr;49(2):355-359. doi: 10.1007/s15010-020-01510-8. Epub 2020 Aug 29.

Abstract

Multidrug-resistant Pseudomonas aeruginosa has limited treatment options. Treatment of healthcare-associated meningitis requires agents active against the organism in vitro and able to penetrate the cerebrospinal fluid adequately. Ceftolozane-tazobactam has been recently approved to treat various Gram-negative organisms, including Pseudomonas aeruginosa; however, ceftolozane's penetration into human cerebrospinal fluid is unknown. Here, we present a case of a patient with multidrug-resistant Pseudomonas aeruginosa meningitis treated with a continuous infusion of ceftolozane-tazobactam. Samples of both serum and cerebrospinal fluid were analyzed for ceftolozane concentration on continuous infusion. Cerebrospinal fluid concentrations of ceftolozane were 83% of that in serum. Treatment with ceftolozane-tazobactam, along with combinations of other antibiotics, resulted in clearance of organism from the patient's cerebrospinal fluid and marked decrease in inflammatory cells. Studies are warranted to determine the efficacy of ceftolozane-tazobactam for patients with healthcare-associated meningitis.

Keywords: Ceftolozane-tazobactam; Cerebrospinal fluid; Meningitis; Pseudomonas aeruginosa.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Cephalosporins / therapeutic use
  • Drug Resistance, Multiple, Bacterial
  • Humans
  • Meningitis*
  • Microbial Sensitivity Tests
  • Penicillanic Acid / therapeutic use
  • Pseudomonas Infections* / drug therapy
  • Pseudomonas aeruginosa
  • Tazobactam

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • ceftolozane
  • Penicillanic Acid
  • Tazobactam