Case report: Continuous infusions of ceftazidime-avibactam and aztreonam in combination through elastomeric infusors for 12 weeks for the treatment of bone and joint infections due to metallo-β-lactamase producing Enterobacterales

Yanis Merad; Anne Conrad; Sophie Brosset; Axel Schmidt; Camille Hanriat; Sebastien Lustig; Frederic Laurent; Camille Kolenda; Tiphaine Roussel-Gaillard; Cecile Batailler; Tristan Ferry; Lyon BJI Study group

doi:10.3389/fmed.2023.1224922

Case report: Continuous infusions of ceftazidime-avibactam and aztreonam in combination through elastomeric infusors for 12 weeks for the treatment of bone and joint infections due to metallo-β-lactamase producing Enterobacterales

Front Med (Lausanne). 2023 Aug 3:10:1224922. doi: 10.3389/fmed.2023.1224922. eCollection 2023.

Authors

Yanis Merad¹, Anne Conrad^{1

2

3

4}, Sophie Brosset^{4

5}, Axel Schmidt^{4

6}, Camille Hanriat^{4

5}, Sebastien Lustig^{2

4

6}, Frederic Laurent^{2

3

4

7}, Camille Kolenda^{2

3

4

7}, Tiphaine Roussel-Gaillard^{3

4

7}, Cecile Batailler^{2

4

6}, Tristan Ferry^{1

2

3

4}; Lyon BJI Study group

Affiliations

¹ Infectious Disease Department, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France.
² Université Claude Bernard Lyon 1, Lyon, France.
³ International Center for Research in Infectiology, INSERM U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France.
⁴ Centre Interrégional de Référence pour la Prise en Charge des Infections Ostéo-Articulaires Complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.
⁵ Plastic and Reconstructive Surgery Department, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France.
⁶ Orthopaedic and Traumatology Surgery Departement, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France.
⁷ Institut des Agents Infectieux, Laboratoire de Bactériologie, Centre National de Référence des Staphylocoques, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.

Abstract

Among carbapenem-resistant Enterobacterales, metallo-beta-lactamase producing strains represent a growing therapeutic challenge. While the association of aztreonam and ceftazidime-avibactam has been investigated in recent years for the treatment of infections involving these strains, little to no clinical data support the use of this association for the treatment of bone and joint infections. We report two cases of complex bone and joint infections involving metallo-beta-lactamase-producing Enterobacterales, successfully treated at our referral center with aztreonam and ceftazidime-avibactam for 12 weeks in continuous infusions through elastomeric infusors.

Keywords: Enterobacterales; antibiotic resistance; aztreonam; bone and joint infections; ceftazidime-avibactam; elastomeric infusor; metallo-beta-lactamase.

Publication types

Case Reports