Table 2 Combination regimens used to treat ensuing septic episodes in our patient
Date of hospitalization in Infectious Diseases Unit | Microbiological data | Combination therapy | Doses | Timing of therapy |
|---|---|---|---|---|
10 April 2016 (first septic episode) | KPC-producing Klebsiella pneumoniae isolates on BCs | Tigecycline Meropenem Colistin | LD 100 mg + 50 mg/12 hours LD 2gr + 2gr/8 hours LD 9 MU + 4.5 MU/8 hours | 18 days |
June 2016 Re-hospitalization for the second septic episode | KPC-producing Klebsiella pneumoniae on BCs | Tigecycline Meropenem Colistin | LD 100 mg + 50 mg/12 hours LD 2gr + 2gr/8 hours LD 9 MU + 4.5 MU/12 hours | 12 days before surgical management for fixators’ removal |
Continuing hospitalization after surgical treatment |  | Same combination therapy as above |  | 21 days |
December. 2016 Third septic recurrence with hospitalization | KPC-producing Klebsiella pneumoniae and Enterobacter aerogenes isolates on BC | Tigecycline Meropenem Colistin Gentamycin | LD 100 mg + 50 mg/12 hours LD 2gr + 2gr/8 hours LD 9 MU +  4.5 MU/8 hours | 14 days |
Septic shock/MOF after discontinuation of therapy (January 2017) | KPC-producing Klebsiella pneumoniae with a progression of a resistance phenotype isolates on BC | Avibactam/ceftazidime (compassionate use) Tigecycline Meropenem Gentamycin | 2gr/8 hours LD 100 mg + 50 mg/12 hours LD 2gr + 2gr/8 hours LD 7 mg/kg per day (480 mg) + 5 mg/kg per day (350 mg/24 hours) | 16 days |