Infection Treatment Caused by Multiple-drug-resistant <i>Pseudomonas aeruginosa</i> in a Patient Underwent Allogeneic Hematopoietic Stem Cell Transplantation

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  • KAWAZOE Hitoshi
    Department of Pharmacy, Kagawa University Hospital, Faculty of Medicine, Kagawa University Department of Clinical Pharmacology, Graduate School of Pharmaceutical Sciences, The University of Tokushima
  • TAKIGUCHI Yoshiharu
    Department of Clinical Pharmacology, Graduate School of Pharmaceutical Sciences, The University of Tokushima
  • INOUE Tatsuya
    Department of Pharmacy, Kagawa University Hospital, Faculty of Medicine, Kagawa University
  • YAMAGUCHI Kazunori
    Department of Pharmacy, Kagawa University Hospital, Faculty of Medicine, Kagawa University
  • TANAKA Hiroaki
    Department of Pharmacy, Kagawa University Hospital, Faculty of Medicine, Kagawa University
  • KAJI Masato
    Department of Pharmacy, Kagawa University Hospital, Faculty of Medicine, Kagawa University
  • TSUJI Shigeko
    Department of Pharmacy, Kagawa University Hospital, Faculty of Medicine, Kagawa University
  • NINOMIYA Masaki
    Department of Pharmacy, Kagawa University Hospital, Faculty of Medicine, Kagawa University
  • FUKUOKA Noriyasu
    Department of Pharmacy, Kagawa University Hospital, Faculty of Medicine, Kagawa University
  • OHNISHI Hiroaki
    Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University
  • ISHIDA Toshihiko
    Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University
  • HOUCHI Hitoshi
    Department of Pharmacy, Kagawa University Hospital, Faculty of Medicine, Kagawa University

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Other Title
  • 同種造血幹細胞移植患者における多剤耐性緑膿菌による感染症治療
  • ドウシュ ゾウケツ カンサイボウ イショク カンジャ ニ オケル タザイ タイセイ リョクノウキン ニ ヨル カンセンショウ チリョウ

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Abstract

  Infections caused by multiple-drug-resistant Pseudomonas aeruginosa (MDRP) are a clinically significant problem. We reported here the effective use of combination therapy in a patient with infection caused by MDRP according to an interventional treatment strategy suggested by a pharmacist. The patient was a 70-year-old male who underwent allogeneic hematopoietic stem cell transplantation. On day 45 after transplant, MDRP was newly isolated from urine, but the diagnosis at that time was colonization. On day 61, the patient developed a fever (≥38.0°C). In addition, laboratory data showed that C-reactive protein (CRP) was also increased. At the medical team conference, the pharmacist proposed the following treatment strategy for this infection. Aztreonam and amikacin were intravenously administered at doses of 2 g/day and 800 mg/day, respectively. The subsequent clinical course was well controlled, but the infection recurred and was aggravated. Aztreonam and ciprofloxacin were then intravenously administered at doses of 4 g/day and 600 mg/day, respectively, resulting in the alleviation of fever in the patient as well as a decrease in CRP and disappearance of MDRP isolates from urine on day 67; that is, MDRP infection was consequently well controlled. In conclusion, the combination therapy between aztreonam and amikacin, or ciprofloxacin may be clinically useful for severe infections of MDRP in compromised hosts.<br>

Journal

  • YAKUGAKU ZASSHI

    YAKUGAKU ZASSHI 128 (4), 657-661, 2008-04-01

    The Pharmaceutical Society of Japan

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