Table 1 Overview of antimicrobial association treatments used in this patient
Days of hospitalization in intensive care | Combination therapy | Doses | Microbiological data | Site of infection |
|---|---|---|---|---|
1–7 | Piperacillin/tazobactam Levofloxacin Linezolid | LD 4.5 gr + 4.5 gr/6 hour 500 mg/12 hour 600 mg/12 hour | Empirical regimen Negative microbiological data from the dispatching ward | Lung Intestine |
7–21 | Daptomycin Tigecycline Meropenem Anidulafungin | 8 mg/Kg (1 gr/day) LD 200 mg + 100 mg/12 hour LD 2 gr + 2 gr/8 hour LD 200 mg + 100 mg/day | Blood cultures: Staphylococcus hominis and Staphylococcus epidermidis Rectal swab: MDR Acinetobacter baumannii | Pelvic insertion sites Intestine Bloodstream |
21–32 | Colimycin (colistin) Tigecycline Meropenem Daptomycin | LD 9 MU + 4.5 MU/12 hour intravenous 1 MU/8 hour nebulized 100 mg/12 hour 2 gr/8 hour 1 gr/day | Blood cultures: negative Urine and tracheal aspirate: KPC-producing Klebsiella pneumoniae and MDR A. baumannii Wounds swab: KPC-producing K. pneumoniae panres | Lung Urinary tract Surgical site |
32–36 | Meropenem Tigecycline | 2 gr/8 hour 100 mg/12 hour | Blood cultures: S. Epidermidis (1 broth) Tracheal aspirate: KPC-producing K. pneumoniae panres | Intestine Surgical site |
36–72 36–68 36–48 48–68 | Colimycin (colistin) Tigecycline Meropenem Rifampicin Anidulafungin Amphotericin | LD 9 MU + 4.5 MU/12 hour intravenous + 1 MU/8 hour nebulized 100 mg/12 hour 2 gr/8 hour 900 mg/day LD 200 mg +100 mg/day 5 mg/kg each second day | SeptiFast: A. baumannii and Candida albicans Tracheal aspirate: A. baumannii and KPC-producing K. pneumoniae Blood cultures: C. albicans and A. baumannii Wound swabs: KPC-producing K. pneumoniae panres Control blood cultures (3 lots): C. albicans A. baumannii and KPC-producing K. pneumoniae panres | Bloodstream Surgical site Intestine |
72–77 | Meropenem Tigecycline | 2 gr/8 hour 100 mg/12 hour | Wound swabs: KPC-producing K. pneumoniae panres | Surgical site |
77–132 | Colimycin (colistin) Meropenem Ertapenem Tigecycline | LD 9 MU + 4.5 MU/12 hour 2 gr/6 hour 1 gr/12 hour 100 mg/12 hour | Surgical wounds and blood cultures: KPC-producing K. pneumoniae panres  and A. baumannii | Surgical site |
132–146 | Meropenem Tigecycline | 2 gr/6 hour 100 mg/12 hour | Rectal swab KPC-producing K. pneumoniae panres Blood cultures negative |  Intestine Blood stream |