Burkholderia cepacia septicemia in a pediatric oncology patient: a pharmacotherapy challenge

The Annals of Pharmacotherapy
Spencer H DurhamChatchawin Assanasen

Abstract

To discuss pharmacotherapy challenges encountered during treatment of a pediatric oncology patient with Burkholderia cepacia septicemia. An 11-year-old male with a history of aplastic anemia presented to the emergency department with a 1-day history of cough and purulent nasal discharge 6 months after undergoing bone marrow transplant. Blood cultures obtained from the patient's Broviac catheter revealed gram-negative rods. Piperacillin/tazobactam and tobramycin were administered, but the patient worsened clinically, with fever and chills. B. cepacia was identified as the offending pathogen, and the therapy was changed to meropenem and ciprofloxacin, as piperacillin/ tazobactam and tobramycin are ineffective against Burkholderia spp. Intravenous trimethoprim/sulfamethoxazole, the drug of choice for Burkholderia spp. infections, was unavailable as it had been placed on national manufacturer backorder. The patient improved initially, but he later experienced recurrence of fever, and blood culture results were positive for Burkholderia spp. Infection was eradicated after removal of the central line and administration of ceftazidime and oral minocycline. Literature reveals few cases of B. cepacia in pediatric oncology patients, and ...Continue Reading

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Citations

Mar 17, 2015·Expert Review of Anti-infective Therapy·Vikas GautamAmit Agarwal

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Methods Mentioned

BETA
pharmacotherapy

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