Ceftriaxone
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Reactions 1489, p12 - 22 Feb 2014 S Ceftriaxone Treatment failure in Escherichia coli bacteraemia: case report A 37-year-old woman experienced treatment failure in Escherichia coli bacteraemia while receiving ceftriaxone. The woman presented with lethargy, dysuria, nausea and chills. Her history included renal transplantation and cellulitis, for which she had started receiving amoxicillin/clavulanic acid 2 days earlier. Tests showed neutrophilia, abnormal urinalysis and elevated CRP levels, and blood cultures were collected. She received IV ceftriaxone 1g or 17 mg/kg [frequency not stated]; however, she continued to be bacteraemic. E. coli was identified in blood and urine cultures, with all isolates having susceptibility to ceftriaxone. The blood culture isolates tested positive for AmpC; β-lactamase induction was also demonstrated. On hospital day 2, ceftriaxone was switched to meropenem. The woman’s inflammatory markers subsequently improved, and her bacteraemia resolved. Author comment: "This case demonstrates a failure of ceftriaxone to clear bacteraemia caused by an organism that tested sensitive to ceftriaxone by multiple methods according to current [Clinical and Laboratory Standards Institute] breakpoints." Papanicolas LE, et al. Ceftriaxone treatment failure in cephalosporin-susceptible Escherichia coli bacteraemia. International Journal of Antimicrobial Agents 41: 298-299, No. 3, Mar 2013. Available from: URL: http://doi.org/10.1016/ j.ijantimicag.2012.11.008 - Australia 803099717 1 Reactions 22 Feb 2014 No. 1489 0114-9954/14/1489-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
Transcript of Ceftriaxone
Reactions 1489, p12 - 22 Feb 2014
SCeftriaxone
Treatment failure in Escherichia coli bacteraemia:case report
A 37-year-old woman experienced treatment failure inEscherichia coli bacteraemia while receiving ceftriaxone.
The woman presented with lethargy, dysuria, nausea andchills. Her history included renal transplantation and cellulitis,for which she had started receiving amoxicillin/clavulanic acid2 days earlier. Tests showed neutrophilia, abnormal urinalysisand elevated CRP levels, and blood cultures were collected.She received IV ceftriaxone 1g or 17 mg/kg [frequency notstated]; however, she continued to be bacteraemic. E. coli wasidentified in blood and urine cultures, with all isolates havingsusceptibility to ceftriaxone. The blood culture isolates testedpositive for AmpC; β-lactamase induction was alsodemonstrated.
On hospital day 2, ceftriaxone was switched to meropenem.The woman’s inflammatory markers subsequently improved,and her bacteraemia resolved.
Author comment: "This case demonstrates a failure ofceftriaxone to clear bacteraemia caused by an organism thattested sensitive to ceftriaxone by multiple methods accordingto current [Clinical and Laboratory Standards Institute]breakpoints."Papanicolas LE, et al. Ceftriaxone treatment failure in cephalosporin-susceptibleEscherichia coli bacteraemia. International Journal of Antimicrobial Agents 41:298-299, No. 3, Mar 2013. Available from: URL: http://doi.org/10.1016/j.ijantimicag.2012.11.008 - Australia 803099717
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Reactions 22 Feb 2014 No. 14890114-9954/14/1489-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
