Afaf H Ghunaim1,2, Ahmad M Alghamdi1,2, Erada M Alghamdi2,3 and Mona Aldabbagh1,2,4*
1Department of Pediatrics, King Abdulaziz Medical City, Saudi Arabia
2King Abdullah International Medical Research Centre, Saudi Arabia
3Department of Emergency Medicine, King Abdulaziz Medical City, Saudi Arabia
4King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
Infection with multi-drug resistant bacteria is an uprising clinical problem that requires the development of new antimicrobial agents. Sulbactam/avibactam increases sulbactam activity against multi-drug resistant Acinetobacter baumannii in vitro; however, it has not been tested clinically yet. Moreover, data about its use in children is limited. A 29-month-old boy was referred with a 40% burn. The patient was on colistin and tigecycline for A. baumannii wound infection. Meropenem was added for Serratia marcescens septicemia. However, repeated tissue culture revealed MDR A. baumannii, which was only sensitive to trimethoprim-sulfamethoxazole (bactrim). The patient had meropenem infusion in addition to Bactrim for three weeks. Unfortunately, the meropenem and bactrim were halted because of treatment failure. Treatment was changed to ceftazidime/avibactam and aztreonam. The patient deteriorated clinically after two days of this regimen; therefore, colistin was added empirically. After one week of persistent fever and elevated inflammatory markers, ceftazidime/avibactam and ampicillin/sulbactam were started. The fever subsided in 48 h, and the inflammatory markers trended down with laboratory evidence of organism clearance after two weeks. This case showed that avibactam/sulbactam could be an option for managing MDR A. baumannii nosocomial infection in children.
Ghunaim AH, Alghamdi AM, Alghamdi EM, Aldabbagh M. Successful Treatment of Acinetobacter baumannii Infection in Burn Child with Avibactam/ Sulbactam: A Case Report. Ann Clin Case Rep. 2022; 7: 2247.