Role of Therapeutic Drug Monitoring in the Treatment of Persistent Mycobacterium abscessus Central Nervous System Infection: A Case Report and Review of the Literature

Author:

Wu En-Ling1ORCID,Al-Heeti Omar1,Hoff Brian M2,Williams Janna L1,Krueger Karen M1,Santoiemma Phillip P1,Rhodes Nathaniel J345ORCID

Affiliation:

1. Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine , Chicago, Illinois , USA

2. Department of Pharmacy, Loyola University Medical Center , Maywood, Illinois , USA

3. Department of Pharmacy Practice, Midwestern University College of Pharmacy, Downers Grove Campus , Downers Grove, Illinois , USA

4. Pharmacometrics Center of Excellence, Midwestern University College of Pharmacy, Downers Grove Campus , Downers Grove, Illinois , USA

5. Department of Pharmacy, Northwestern Medicine , Chicago, Illinois , USA

Abstract

Abstract A patient presenting with recurrent ventriculoperitoneal shunt infection was found to have Mycobacterium abscessus growing from cerebrospinal fluid (CSF), which remained persistently positive. Therapeutic monitoring of clarithromycin, imipenem, and linezolid in CSF and plasma revealed lower than expected concentrations, prompting alternative therapy and culture clearance on hospital day 42.

Funder

National Center for Advancing Translational Sciences

NIH

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

Reference12 articles.

1. Mycobacterium abscessus complex infections in humans;Lee;Emerg Infect Dis,2015

2. Mycobacterium abscessus: a new antibiotic nightmare;Nessar;J Antimicrob Chemother,2012

3. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline;Daley;Eur Respir J,2020

4. Penetration of drugs through the blood-cerebrospinal fluid/blood-brain barrier for treatment of central nervous system infections;Nau;Clin Microbiol Rev,2010

5. Pharmacokinetics of bedaquiline in cerebrospinal fluid and serum in multidrug-resistant tuberculous meningitis;Akkerman;Clin Infect Dis,2016

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