Dual β-lactam for treatment of pulmonary Mycobacterium abscessus in a child

• Published in: Antimicrobial agents and chemotherapy 2024-07, Vol.68 (7), p.e0031924
• Main Authors: Becken, Bradford, Dousa, Khalid M, Johnson, John L, Holland, Steven M, Bonomo, Robert A
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; beta-Lactams - pharmacology; beta-Lactams - therapeutic use; Challenging Clinical Case in Antimicrobial Resistance; Child; Drug Therapy, Combination; Editor’s Pick; Humans; Male; Microbial Sensitivity Tests; Mycobacteriology; Mycobacterium abscessus - drug effects; Mycobacterium Infections, Nontuberculous - drug therapy; Mycobacterium Infections, Nontuberculous - microbiology
• ISSN: 0066-4804; 1098-6596; 1098-6596
• DOI: 10.1128/aac.00319-24

Treatment of infection presents significant challenges, exacerbated by the emergence of macrolide-resistant strains that necessitate the use of multiple antimicrobials in combination and carry the potential for significant toxic effects. Select dual beta-lactam combinations, with or without beta-lactamase inhibitors, have been shown to be highly active . Herein, we describe a 6-year-old child with underlying mild bilateral lower lobe cylindrical bronchiectatic lung disease who developed pulmonary infection and was treated with a multi-drug regimen including two β-lactam antibiotics, achieving both early clinical and microbiological cure. This case highlights the potential benefit of dual β-lactam therapy for the treatment of drug-resistant infection.