Continuous beta-lactam antibiotic therapy in a double-lung transplanted patient with a multidrug-resistant Pseudomonas aeruginosa infection.
BACKGROUND
It is well known that the bactericidal effect of beta-lactam antibiotics is closely related to the time which the serum concentration of the antibiotic remains above the minimal inhibitory concentration of the target pathogen. Thus, the optimal administration of beta-lactam antibiotics would be the continuous infusion of the drug.


METHODS
We present a case report with a critically ill double-lung transplanted patient with pneumonia due to a multidrug-resistant Pseudomonas aeruginosa who received continuously 8 g meropenem/24 hr. Based on a previous pharmacokinetic study showing that continuous infusion of meropenem is at least equivalent to intermittent administration this case report is reported to demonstrate the clinical efficacy of continuous infusion.


RESULTS
C-reactive protein and pneumonia decreased rapidly when clinical conditions were improved significantly. Continuous administration of meropenem did not interfere with cyclosporine, no side effects were seen, and the patient's renal function was not impaired during the whole period of treatment.


CONCLUSIONS
The continuous administration of beta-lactam antibiotics is a powerful application in critically ill patients to intensify antimicrobial therapy.
Domenig
C
C
Department of Surgery, University Hospital Vienna, Austria.
Traunmüller
F
F
Kozek
S
S
Wisser
W
W
Klepetko
W
W
Steininger
R
R
Spiss
C
C
Thalhammer
F
F
D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D018432:Drug Resistance, Multiple; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy*; D018440:beta-Lactam Resistance / Q000502:physiology*; D047090:beta-Lactams
D000900:Anti-Bacterial Agents; D047090:beta-Lactams