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Ceftolozane/tazobactam for Pseudomonas aeruginosa pulmonary exacerbations in cystic fibrosis adult patients: a case series

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Abstract

Management of cystic fibrosis (CF) patients colonized with Pseudomonas aeruginosa is challenging due to its virulence and multi-drug resistance. Ceftolozane/tazobactam (C/T) is a promising new antipseudomonal agent, and clinical data on CF are limited. We describe our experience in the use of C/T for P. aeruginosa-related pulmonary exacerbations (PE) in CF adults admitted within 2016 and 2019 at Careggi Hospital, Florence, Italy. PE was diagnosed as deterioration of respiratory function, worsening cough, and increasing of sputum. C/T was given at the dose of 3 g every 8 h. C/T was used in ten patients. Mean length of C/T treatment was 16.3 days, and tobramycin was the most frequently combined antipseudomonal agent. All patients were successfully treated although susceptibility testing on sputum sample showed C/T resistance in two cases. No adverse effects related to C/T were reported. To our knowledge this is the largest case series on CF patients treated with C/T. Clinical responses were encouraging even where C/T resistant P. aeruginosa was isolated, probably due to multiple phenotypes colonizing CF lungs. C/T could play a promising role in combination therapy against P. aeruginosa as a part of a colistin-sparing regime.

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Authors and Affiliations

  1. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Letizia Ottino, Ilaria Baccani, Gian Maria Rossolini & Alessandro Bartoloni

  2. Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy

    Filippo Bartalesi, Beatrice Borchi, Silvia Bresci, Annalisa Cavallo & Alessandro Bartoloni

  3. Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy

    Gian Maria Rossolini

Authors
  1. Letizia Ottino
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  2. Filippo Bartalesi
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  3. Beatrice Borchi
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  4. Silvia Bresci
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  5. Annalisa Cavallo
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  6. Ilaria Baccani
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  7. Gian Maria Rossolini
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  8. Alessandro Bartoloni
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Contributions

Conceptualization: Letizia Ottino, Filippo Bartalesi, and Silvia Bresci. Methodology: Letizia Ottino, Filippo Bartalesi, and Silvia Bresci. Formal analysis and investigation: Letizia Ottino, Beatrice Borchi, and Ilaria Baccani. Writing—original draft preparation: Letizia Ottino. Writing—review and editing: Filippo Bartalesi, Beatrice Borchi, Annalisa Cavallo, Silvia Bresci, and Gian Maria Rossolini. Supervision: Gian Maria Rossolini and Alessandro Bartoloni.

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Correspondence to Letizia Ottino.

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Ottino, L., Bartalesi, F., Borchi, B. et al. Ceftolozane/tazobactam for Pseudomonas aeruginosa pulmonary exacerbations in cystic fibrosis adult patients: a case series. Eur J Clin Microbiol Infect Dis 40, 2211–2215 (2021). https://doi.org/10.1007/s10096-021-04218-1

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  • DOI: https://doi.org/10.1007/s10096-021-04218-1

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