Tigecycline to treat Stenotrophomonas maltophilia ventilator‐associated pneumonia in a trauma intensive care unit as a result of a drug shortage: A case series

Autor:	Julie Elizabeth Farrar, Martin A. Croce, Katelyn M. Garner, Louis J. Magnotti, G. Christopher Wood, Joseph M. Swanson
Rok vydání:	2020
Předmět:	Drug medicine.medical_specialty media_common.quotation_subject Tigecycline 030226 pharmacology & pharmacy 03 medical and health sciences 0302 clinical medicine medicine Pharmacology (medical) 030212 general & internal medicine Intensive care medicine Adverse effect media_common Pharmacology biology business.industry Sulfamethoxazole Ventilator-associated pneumonia bacterial infections and mycoses medicine.disease biology.organism_classification Trimethoprim respiratory tract diseases Pneumonia Stenotrophomonas maltophilia business medicine.drug
Zdroj:	Journal of Clinical Pharmacy and Therapeutics. 45:836-839
ISSN:	1365-2710 0269-4727
DOI:	10.1111/jcpt.13158
Popis:	What is known and objective Stenotrophomonas maltophilia is an intrinsically multidrug-resistant (MDR) organism which commonly presents as a respiratory tract infection. S. maltophilia is typically treated with high-dose sulfamethoxazole/trimethoprim (SMX/TMP). However, SMX/TMP and other treatment options for S. maltophilia can be limited because of resistance, allergy, adverse events or unavailability of the drug; use of novel agents may be necessary to adequately treat this MDR infection and overcome these limitations. Case description This small case series describes two patients who underwent treatment with tigecycline for ventilator-associated pneumonia (VAP) caused by S. maltophilia after admission to a trauma intensive care unit. At the time of admission for the two reported patients, a national drug shortage of intravenous (IV) SMX/TMP prevented its use. Tigecycline was chosen as a novel agent to treat S. maltophilia VAP based on culture and susceptibility data, and it was used successfully. Both patients showed clinical signs of improvement with eventual cure and discharge from the hospital after treatment with tigecycline, and one patient demonstrated confirmed microbiological cure with a negative repeat bronchoscopic bronchoalveolar lavage (BAL). What is new and conclusion To our knowledge, this small case series is the first documentation of utilizing tigecycline to treat S. maltophilia VAP in the United States. Although it likely should not be considered as a first-line agent, tigecycline proved to be an effective treatment option in the two cases described in the setting of a national drug shortage of the drug of choice.
Databáze:	OpenAIRE
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