Evidence map›Paper›PMID 30665450›Full record

ArticleJournal of medical case reports2019

Cure of recurring Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae septic shock episodes due to complicated soft tissue infection using a ceftazidime and avibactam-based regimen: a case report.

Giustino Parruti, Antonella Frattari, Ennio Polilli, Vincenzo Savini, Antonina Sciacca, Augusta Consorte, Donatella Concetta Cibelli, Adriana Agostinone, Francesco Di Masi, Alessandro Pieri and 4 more

Open access · goldAbstract readCase Reports
In one paragraph

Article in Journal of medical case reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Giustino ParrutiInfectious Diseases Unit, Pescara General Hospital, Via Fonte Romana 8, 65124, Pescara, Italy. parruti@tin.it.
Antonella FrattariAnaesthesia and Intensive Care Unit, Pescara General Hospital, Pescara, Italy.
Ennio PolilliClinical Pathology Unit, Pescara General Hospital, Pescara, Italy.
Vincenzo SaviniMicrobiology and Virology Unit, Pescara General Hospital, Pescara, Italy.
Antonina SciaccaInfectious Diseases Unit, Pescara General Hospital, Via Fonte Romana 8, 65124, Pescara, Italy.
Augusta ConsorteInfectious Diseases Unit, Pescara General Hospital, Via Fonte Romana 8, 65124, Pescara, Italy.
Donatella Concetta CibelliInfectious Diseases Unit, Pescara General Hospital, Via Fonte Romana 8, 65124, Pescara, Italy.
Adriana AgostinoneInfectious Diseases Unit, Pescara General Hospital, Via Fonte Romana 8, 65124, Pescara, Italy.
Francesco Di MasiInfectious Diseases Unit, Pescara General Hospital, Via Fonte Romana 8, 65124, Pescara, Italy.
Alessandro PieriInfectious Diseases Unit, Pescara General Hospital, Via Fonte Romana 8, 65124, Pescara, Italy.
Pierluigi CacciatoreInfectious Diseases Unit, Pescara General Hospital, Via Fonte Romana 8, 65124, Pescara, Italy.
Giancarlo Di IorioClinical Pathology Unit, Pescara General Hospital, Pescara, Italy.
Paolo FaziiMicrobiology and Virology Unit, Pescara General Hospital, Pescara, Italy.
Tullio SpinaAnaesthesia and Intensive Care Unit, Pescara General Hospital, Pescara, Italy.
Azienda USL di Pescara · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInfections caused by multidrug-resistant Enterobacteriaceae are hard to treat and life-threatening due to reduced therapeutic options. Systemic infections caused by Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae strains have increased in many European regions, becoming frequent in many clinical settings, and are associated with high mortality. The co-formulation of ceftazidime, a third-generation cephalosporin, with avibactam, a new suicide inhibitor beta-lactamase inhibitor able to block most Klebsiella pneumoniae carbapenemases, has been recently licensed, with promising results in patients with limited or absent therapeutic options. Little is known, however, as to the efficacy of such a combination in patients with soft tissue infections caused by multidrug-resistant Klebsiella pneumoniae carbapenemase-producing strains of Klebsiella pneumoniae. CASE PRESENTATION: A Caucasian 53-year-old man with paraplegia suffered multiple vertebral fractures due to a car crash. He was treated with external fixators that became infected early after insertion and were repeatedly and inefficiently treated with multiple antibiotics. He suffered repeated septic episodes caused by Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae strains with a multidrug-resistant profile. Meropenem, tigecycline, and colistin combinations allowed only temporary improvements, but septic shock episodes recurred, in spite of removal of infected external fixators. After approval of pre-marketing prescription by our local Ethics Committee, full clinical resolution was obtained with a compassionate treatment using meropenem and ceftazidime/avibactam in combination for 16 days.

conclusionsOur experience provides additional evidence that ceftazidime/avibactam, possibly in combination with meropenem rescued by avibactam, may be an efficacious treatment option also for complicated skin and soft tissue infections caused by multidrug-resistant strains of Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae.

Indexed as

Anti-Bacterial AgentsAzabicyclo CompoundsCeftazidimeDevice RemovalDrug CombinationsDrug Resistance, Multiple, BacterialExternal FixatorsFracture FixationHumansKlebsiella InfectionsMaleMiddle AgedParaplegiaProsthesis-Related InfectionsShock, SepticSoft Tissue InfectionsAnti-Bacterial Agentsavibactam, ceftazidime drug combinationAzabicyclo CompoundsCeftazidimeDrug CombinationsKlebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniaeSepsisTreatment

Identifiers

PMID30665450
PMCPMC6341597
OpenAlexW2913971562

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.