Treatment of Polymicrobial Osteomyelitis with Ceftolozane-Tazobactam: Case Report and Sensitivity Testing of Isolates
Stenotrophomonas maltophiliais an inherently multidrug resistant (MDR) opportunistic pathogen with many mechanisms of resistance. SENTRY studies reveal decreasing sensitivities ofS. maltophiliato trimethoprim-sulfamethoxazole and fluoroquinolones. Ceftolozane-tazobactam (Zerbaxa, Merck & Co., Inc.) a novel intravenous combination agent of a third-generation cephalosporin andβ-lactamase inhibitor was demonstrated to havein vitroactivity 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-resistantPseudomonas aeruginosapneumonia. Herein, we describe the first published case of treatment of MDRS. maltophiliain 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 MDRS. maltophilia.