Vol.62 No.4 July 2014
Effect of combination therapy of tigecycline and colistin against a case of catheter-related bloodstream infection by multidrug-resistant Acinetobacter baumannii
1)Department of Pharmacy, Hokkaido University Hospital, Kita-14-jo, Nishi-5, Kita-ku, Sapporo, Hokkaido, Japan
2)Department of Hematology, Hokkaido University Graduate School of Medicine
3)Division of Laboratory and Transfusion Medicine, Hokkaido University
4)Infection Control Team, Hokkaido University
5)Laboratory of Clinical Pharmaceutics and Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University
Abstract
A 34-year-old man who had undergone bone marrow transplantation 10 years previously due to chronic leukemia was being administered an immunosuppressant on an outpatient basis. He was admitted to hospital due to pneumonia and levofloxacin was administered intravenously. His symptoms improved temporarily, but severe fever and elevation of CRP occurred. Multidrug-resistant Acinetobacter baumannii(MDRAB) was detected from his catheter tip, so a diagnosis of catheter-related bloodstream infection of MDRAB was made. Tigecycline treatment concomitant with colistin was started. MDRAB was not detected in a blood culture the day after initiation of therapy, and body temperature decreased to the normal level. The CRP level became normal 10 days after the initiation of tigecycline and colistin treatment. Colistin is known for its severe renal toxicity; however, we monitored its trough blood level, enabling us to use it safely during therapy. Since MDRAB infection often results in sepsis, combination treatment of tigecycline and colistin may be more effective for this condition.
Key word
tigecycline, colistin, Acinetobacter baumannii, blood stream infection
Received
March 1, 2014
Accepted
May 23, 2014
Jpn. J. Chemother. 62 (4): 501-505, 2014
