Successful use of outpatient parenteral antimicrobial therapy (OPAT) aztreonam-avibactam in a pediatric case of an infectious pseudoarthrosis caused by NDM-producing Klebsiella pneumoniae and Pseudomonas aeruginosa.
Maite Bosch-Peligero, Carla Codina-Jimenez, Cristian Chaguaceda Galisteo et al.
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Case in brief
A 9-year-old girl with war-related trauma developed infectious pseudoarthrosis of the distal tibia due to NDM-producing Klebsiella pneumoniae and Pseudomonas aeruginosa. After surgical intervention and microbiological confirmation, she was treated with aztreonam-avibactam via outpatient parenteral antimicrobial therapy (OPAT). Despite a transient rise in liver enzymes requiring a brief treatment pause, she completed six weeks of therapy with good tolerance and no recurrence of infection.
Diagnostic / clinical pearl
This case demonstrates the effectiveness of aztreonam-avibactam in treating pediatric osteoarticular infections caused by multidrug-resistant organisms, emphasizing the viability of OPAT in such complex cases.