title: Treatment of Polymicrobial Osteomyelitis with Ceftolozane-Tazobactam: Case Report and Sensitivity Testing of Isolates.
abstract: Stenotrophomonas maltophilia is an inherently multidrug resistant (MDR) opportunistic pathogen with many mechanisms of resistance. SENTRY studies reveal decreasing sensitivities of S. maltophilia to trimethoprim-sulfamethoxazole and fluoroquinolones. Ceftolozane-tazobactam (Zerbaxa, Merck & Co., Inc.) a novel intravenous combination agent of a third-generation cephalosporin and β-lactamase inhibitor was demonstrated to have in vitro activity against many Gram-positive, Gram-negative, and MDR organisms. Data for ceftolozane-tazobactam's use outside of Food and Drug Administration (FDA) approved indications has been limited thus far to two case reports which demonstrated its efficacy in pan-resistant Pseudomonas aeruginosa pneumonia. Herein, we describe the first published case of treatment of MDR S. maltophilia in polymicrobial osteomyelitis with long-term (>14 days) ceftolozane-tazobactam and metronidazole. Ceftolozane-tazobactam may offer a possible alternative for clinicians faced with limited options in the treatment of resistant pathogens including MDR S. maltophilia.
authors.affiliation: Kern Medical, 1700 Mount Vernon Avenue, Bakersfield, CA 93306-4018, USA; University of the Pacific School of Pharmacy & Health Sciences, 3601 Pacific Avenue, Stockton, CA 95211-0109, USA.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Jolliff
authors.affiliation: Kern Medical, 1700 Mount Vernon Avenue, Bakersfield, CA 93306-4018, USA.
authors.forename: Jackie
authors.identifier: 0000-0003-4942-5176
authors.initials: J
authors.lastname: Ho
authors.affiliation: Kern Medical, 1700 Mount Vernon Avenue, Bakersfield, CA 93306-4018, USA; University of the Pacific School of Pharmacy & Health Sciences, 3601 Pacific Avenue, Stockton, CA 95211-0109, USA.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Joson
authors.affiliation: Kern Medical, 1700 Mount Vernon Avenue, Bakersfield, CA 93306-4018, USA.
authors.forename: Arash
authors.initials: A
authors.lastname: Heidari
authors.affiliation: Kern Medical, 1700 Mount Vernon Avenue, Bakersfield, CA 93306-4018, USA.
authors.forename: Royce
authors.initials: R
authors.lastname: Johnson