Clinical Outcomes of Ceftazidime-Avibactam Against Carbapenem-Resistant Enterobacteriaceae in Descending Necrotising Mediastinitis: Case Report and Literature Review
Febriana Rizky Ramadhani*, Wuryantoro and David Hutagaol
ABSTRACT
Background: Current antibiotic options for carbapenem-resistant Enterobacteriaceae (CRE) are limited. However, anagement of patients with descending necrotizing mediastinitis (DNM) colonized with CRE is urgently required, as it is associated with significant post-operative morbidity and mortality. Ceftazidime-avibactam represents a novel combination therapy for CRE.
Case Presentation: A 50-year-old male patient with clinical DNM and prolonged intensice care. The patient underwent repeated surgeries and experienced infections with K. Pneumoniae, Acinetobacter Sp., and Pseudomonas Sp. resistant to carbapenems. The patient was administered ceftazidime-avibactam for 6 days. However, the patient was declared death after 30-days.
Discussion: The administration of ceftazidime-avibactam yielded good clinical outcomes in CRE infections. Combination therapy had a higher survival rate
compared to monotherapy and lower rates of resistance.
Conclusion: Ceftazidime-avibactam demonstrates effective and safe potential for the management of CRE infections.
