Continuous infusion of ceftolozane-tazobactam resulted in high cerebrospinal fluid concentrations of ceftolozane in a patient with multidrug-resistantPseudomonas aeruginosameningitis

Multidrug-resistantPseudomonas aeruginosahas limited treatment options. Treatment of healthcare-associated meningitis requires agents active against the organism in vitro and able to penetrate the cerebrospinal fluid adequately. Ceftolozane-tazobactam has been recently approved to treat various Gram-negative organisms, includingPseudomonas aeruginosa; however, ceftolozane's penetration into human cerebrospinal fluid is unknown. Here, we present a case of a patient with multidrug-resistantPseudomonas aeruginosameningitis treated with a continuous infusion of ceftolozane-tazobactam. Samples of both serum and cerebrospinal fluid were analyzed for ceftolozane concentration on continuous infusion. Cerebrospinal fluid concentrations of ceftolozane were 83% of that in serum. Treatment with ceftolozane-tazobactam, along with combinations of other antibiotics, resulted in clearance of organism from the patient's cerebrospinal fluid and marked decrease in inflammatory cells. Studies are warranted to determine the efficacy of ceftolozane-tazobactam for patients with healthcare-associated meningitis.

Automated summary

Ceftolozane-tazobactam has been approved for treating multidrug-resistant Pseudomonas aeruginosa meningitis, with cerebrospinal fluid concentrations reaching 83% of serum levels. Combined with other antibiotics, treatment led to clearance of the organism from the patient's cerebrospinal fluid and significant reduction in inflammatory cells.