Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Aug 6;69(8):e0017225.
doi: 10.1128/aac.00172-25. Epub 2025 Jun 2.

Aztreonam plus ceftazidime-avibactam for post-neurosurgical meningitis due to Stenotrophomonas maltophilia

Jonathan Wong-So  1 , Sophie Magréault  2   3 , Étienne Carbonnelle  4 , Vincent Jullien  2   3 , Maxime Desgrouas  1 , Thierry Boulain  1 , François Barbier  1
Affiliations
Case Reports

Aztreonam plus ceftazidime-avibactam for post-neurosurgical meningitis due to Stenotrophomonas maltophilia

Jonathan Wong-So et al. Antimicrob Agents Chemother. .

Abstract

Clinical evidence is lacking regarding the efficacy of aztreonam-avibactam in severe infections involving Stenotrophomonas maltophilia. We report a case of post-neurosurgical meningitis due to S. maltophilia (minimal inhibitory concentration of aztreonam plus avibactam, 4/4 µg/mL) clinically and microbiologically cured with a combination of aztreonam and ceftazidime-avibactam (2 g and 2 g/500 mg q8h, 3 h simultaneous infusions). Therapeutic drug monitoring showed adequate concentrations of aztreonam and avibactam in the cerebrospinal fluid at each time point over the 14-day treatment duration.

Keywords: Stenotrophomonas maltophilia; aztreonam; ceftazidime-avibactam; central nervous system infections; therapeutic drug monitoring.

PubMed Disclaimer

Conflict of interest statement

F.B. declares lecture fees from MSD and Advanz Pharma, consulting fees from Shionogi, conference invitation from Pfizer, and a research grant from MSD. All other authors declare that they have no potential conflict of interest related to the submitted work.

Figures

Fig 1
Fig 1
Temporal evolution of the cerebrospinal fluid-to-plasma concentration ratios of aztreonam, ceftazidime, and avibactam. CSF, cerebrospinal fluid; AZT, aztreonam; CAZ, ceftazidime; AVI, avibactam.
See this image and copyright information in PMC

Comment in

References

    1. Barbier F, Hraiech S, Kernéis S, Veluppillai N, Pajot O, Poissy J, Roux D, Zahar J-R, French Intensive Care Society . 2023. Rationale and evidence for the use of new beta-lactam/beta-lactamase inhibitor combinations and cefiderocol in critically ill patients. Ann Intensive Care 13:65. doi: 10.1186/s13613-023-01153-6 - DOI - PMC - PubMed
    1. Mojica MF, Papp-Wallace KM, Taracila MA, Barnes MD, Rutter JD, Jacobs MR, LiPuma JJ, Walsh TJ, Vila AJ, Bonomo RA. 2017. Avibactam restores the susceptibility of clinical isolates of Stenotrophomonas maltophilia to aztreonam. Antimicrob Agents Chemother 61:e00777-17. doi: 10.1128/AAC.00777-17 - DOI - PMC - PubMed
    1. Sader HS, Duncan LR, Arends SJR, Carvalhaes CG, Castanheira M. 2020. Antimicrobial activity of aztreonam-avibactam and comparator agents when tested against a large collection of contemporary Stenotrophomonas maltophilia isolates from medical centers worldwide. Antimicrob Agents Chemother 64:e01433-20. doi: 10.1128/AAC.01433-20 - DOI - PMC - PubMed
    1. Tamma PD, Heil EL, Justo JA, Mathers AJ, Satlin MJ, Bonomo RA. 2024. Infectious Diseases Society of America 2024 guidance on the treatment of antimicrobial-resistant Gram-negative infections. Clin Infect Dis:ciae403. doi: 10.1093/cid/ciae403 - DOI - PubMed
    1. European Society of Clinical Microbiology and Infectious diseases . 2024. Comité de l’Antibiogramme de la Société Française de Microbiologie. European committee for Antimicrobial Susceptibility Testing. https://www.sfm-microbiologie.org/wp-content/uploads/2024/06/CASFM2024_V....

Publication types

MeSH terms

LinkOut - more resources