colistin and Bile-Duct-Diseases

Both bacteremia and biliary cast syndrome are serious post-transplant complications in liver transplant recipients. In the setting of increasing drug resistance in the current era, management of infections caused by multidrug-resistant (MDR) bacteria has proven challenging. We present a case of a liver transplant recipient who developed biliary cast syndrome and intractable MDR Pseudomonas bacteremia that failed to resolve with conventional antimicrobial therapy and which was finally controlled by a novel combination regimen of colistimethate, doripenem, and tobramycin. Future studies validating the clinical efficacy of this combination strategy are warranted.

Topics: Anti-Bacterial Agents; Bacteremia; Bile Duct Diseases; Carbapenems; Colistin; Doripenem; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Humans; Liver Transplantation; Male; Microbial Sensitivity Tests; Middle Aged; Pseudomonas aeruginosa; Pseudomonas Infections; Tobramycin; Treatment Outcome