Ceftobiprole in the Management of Severe Legionella pneumophila Pneumonia in Critically Ill Patients: Two Illustrative Case Reports
Abstract
Legionella pneumophila is a pathogen responsible for severe ‘atypical pneumonia’ and is often associated with high mortality rates in hospitalized patients. Atypical pneumonia can progress to severe forms with fatal outcomes, causing multi-organ damage. The standard of care involves antibiotics such as fluoroquinolones and macrolides, therapies which can be limited by toxicity or emerging resistance. We report two complex cases of Legionella pneumonia not responsive to other antibiotics. Both cases involved ceftobiprole administration in combination with or following macrolide therapy, and in one case, also addressed a documented co-infection. In the first case, levofloxacin was discontinued due to neurotoxicity, and treatment was successfully switched to ceftobiprole combined with azithromycin, leading to complete clinical and radiological recovery. In the second case, ceftobiprole was administered for a concurrent Staphylococcus aureus infection, and a carbapenem-resistant Acinetobacter baumannii (CRAB) was subsequently managed with an alternative agent, eravacycline. This highlights the complexity of managing polymicrobial infections and the need for adaptable antimicrobial strategies. Ceftobiprole may represent a useful component of an individualized antimicrobial strategy in selected critically ill patients with severe Legionella pneumonia, particularly when first-line agents are contraindicated or concomitant bacterial infections require additional coverage. Although…
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Ferulic acid regulates the AKT/GSK-3β/CRMP-2 signaling pathway in a middle cerebral artery occlusion animal model
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
- Neuroprotective Effects of Epicatechin against Oxidative Stress-Induced Cognitive Impairment: A Systematic Review and Meta-Analysis
- Photochemical behavior of levofloxacin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.