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The successful treatment of a multidrug-resistant Achromobacter xylosoxidans corneal ulcer with topical meropenem.
BMJ Case Rep. 2018 Jul 18; 2018BC

Abstract

Microbial keratitis is a common corneal condition, with many known risk factors. We present a case of an 88-year-old female patient with a multidrug-resistant Achromobacter xylosoxidans corneal ulcer in a previously failed second penetrating keratoplasty, successfully managed with topical meropenem drops administered hourly around the clock, for five days preceding and then hourly day only, for five days following a repeat third penetrating keratoplasty. Topical meropenem 50 mg/mL was prepared by mixing a 500 mg vial of meropenem with 10 mL of sterile water with pharmacy advice that administration should be within an hour. To the best of our knowledge, this is the first report of the use of topical meropenem in the management of A.xylosoxidans keratitis. This case highlights the importance of the mean inhibitory concentrations for antibiotics when considering sensitivities. Topical meropenem may be a useful treatment option for multidrug-resistant bacterial corneal ulcers that are resistant to conventional therapy.

Authors+Show Affiliations

Cornea, Anterior Segment and Refractive Surgery, Bristol Eye Hospital, Bristol, UK.Cornea, Anterior Segment and Refractive Surgery, Bristol Eye Hospital, Bristol, UK.Microbiology and Infectious Diseases, Bristol Royal Infirmary, Bristol, UK.Cornea, Anterior Segment and Refractive Surgery, Bristol Eye Hospital, Bristol, UK.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30021738

Citation

Tavassoli, Shokufeh, et al. "The Successful Treatment of a Multidrug-resistant Achromobacter Xylosoxidans Corneal Ulcer With Topical Meropenem." BMJ Case Reports, vol. 2018, 2018.
Tavassoli S, Gunn D, Williams OM, et al. The successful treatment of a multidrug-resistant Achromobacter xylosoxidans corneal ulcer with topical meropenem. BMJ Case Rep. 2018;2018.
Tavassoli, S., Gunn, D., Williams, O. M., & Darcy, K. (2018). The successful treatment of a multidrug-resistant Achromobacter xylosoxidans corneal ulcer with topical meropenem. BMJ Case Reports, 2018. https://doi.org/10.1136/bcr-2018-225163
Tavassoli S, et al. The Successful Treatment of a Multidrug-resistant Achromobacter Xylosoxidans Corneal Ulcer With Topical Meropenem. BMJ Case Rep. 2018 Jul 18;2018 PubMed PMID: 30021738.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The successful treatment of a multidrug-resistant Achromobacter xylosoxidans corneal ulcer with topical meropenem. AU - Tavassoli,Shokufeh, AU - Gunn,David, AU - Williams,O Martin, AU - Darcy,Kieren, Y1 - 2018/07/18/ PY - 2018/7/20/entrez PY - 2018/7/20/pubmed PY - 2018/11/18/medline KW - eye KW - ophthalmology JF - BMJ case reports JO - BMJ Case Rep VL - 2018 N2 - Microbial keratitis is a common corneal condition, with many known risk factors. We present a case of an 88-year-old female patient with a multidrug-resistant Achromobacter xylosoxidans corneal ulcer in a previously failed second penetrating keratoplasty, successfully managed with topical meropenem drops administered hourly around the clock, for five days preceding and then hourly day only, for five days following a repeat third penetrating keratoplasty. Topical meropenem 50 mg/mL was prepared by mixing a 500 mg vial of meropenem with 10 mL of sterile water with pharmacy advice that administration should be within an hour. To the best of our knowledge, this is the first report of the use of topical meropenem in the management of A.xylosoxidans keratitis. This case highlights the importance of the mean inhibitory concentrations for antibiotics when considering sensitivities. Topical meropenem may be a useful treatment option for multidrug-resistant bacterial corneal ulcers that are resistant to conventional therapy. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/30021738/The_successful_treatment_of_a_multidrug_resistant_Achromobacter_xylosoxidans_corneal_ulcer_with_topical_meropenem_ L2 - https://casereports.bmj.com/cgi/pmidlookup?view=long&pmid=30021738 DB - PRIME DP - Unbound Medicine ER -