{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:16:31Z","timestamp":1780964191497,"version":"3.54.1"},"reference-count":28,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,12,19]]},"abstract":"<jats:p>According to the Centers for Disease Control and Prevention (CDC), approximately 51 000 healthcare-associated infections caused by <jats:italic>Pseudomonas aeruginosa<\/jats:italic> occur annually in the USA, more than 6000 of which (13%) are caused by multidrug resistant (MDR) strains. Ceftolozane\/tazobactam (TOL\/TAZ) (Zerbaxa) was approved by the US Food and Drug Administration (FDA) in December 2014 for the treatment of complicated intra-abdominal and urinary tract infections. At this time, clinical data on the role of TOL\/TAZ treatment outside of FDA-approved indications is limited. Herein, we present a case of extensively drug-resistant (XDR) <jats:italic>P. aeruginosa<\/jats:italic> osteomyelitis of the upper extremity, which was successfully treated with TOL\/TAZ for 8 weeks with optimal clinical and laboratory responses. Monotherapy with TOL\/TAZ appears effective for treatment of complicated bone and joint infections with XDR <jats:italic>P. aeruginosa<\/jats:italic> in combination with comprehensive surgical management, particularly when few antibiotic options exist.<\/jats:p>","DOI":"10.1136\/bcr-2017-223202","type":"journal-article","created":{"date-parts":[[2018,1,5]],"date-time":"2018-01-05T08:46:55Z","timestamp":1515142015000},"page":"bcr-2017-223202","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Treatment of a complex orthopaedic infection due to extensively drug-resistant <i>Pseudomonas aeruginosa<\/i>"],"prefix":"10.1136","volume":"2018","author":[{"given":"Sidra","family":"Hassan","sequence":"first","affiliation":[{"name":"Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mani D","family":"Kahn","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Saraiya","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Montefiore Wakefield Campus, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Nori","sequence":"additional","affiliation":[{"name":"Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,1,5]]},"reference":[{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.2","first-page":"938","article-title":"Antibiotic resistance threats in the United States: stepping back from the brink","volume":"89","author":"Solomon","year":"2014","journal-title":"Am Fam Physician"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.3","doi-asserted-by":"publisher","DOI":"10.1086\/512820"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.4","doi-asserted-by":"crossref","unstructured":"Seifert H , K\u00f6rber-Irrgang B , Kresken M ; German Ceftolozane\/Tazobactam Study Group. In-vitro activity of ceftolozane\/tazobactam against Pseudomonas aeruginosa and Enterobacteriaceae isolates recovered from hospitalized patients in Germany. Int J Antimicrob Agents 2017.doi:10.1016\/j.ijantimicag.2017.06.024","DOI":"10.1016\/j.ijantimicag.2017.06.024"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.5","doi-asserted-by":"crossref","unstructured":"Munita JM , Arias CA . Mechanisms of Antibiotic Resistance. Microbiol Spectr 2016:4.","DOI":"10.1128\/microbiolspec.VMBF-0016-2015"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.6","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00040-09"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.7","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-013-0168-2"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.8","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.mcna.2016.03.012","article-title":"New approaches to antibiotic use and review of recently approved antimicrobial agents","volume":"100","author":"Hahn","year":"2016","journal-title":"Med Clin North Am"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2007.05.019"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.10","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq248"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.11","unstructured":"Merck Sharp & Dohme Corp. Zerbaxa (package insert). Syracuse, NY: Merck Sharp & Dohme Corp, 2015."},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.12","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01752-10"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.13","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01590-12"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.14","doi-asserted-by":"crossref","first-page":"2678","DOI":"10.1093\/jac\/dkx172","article-title":"Successful treatment of post-surgical osteomyelitis caused by XDR Pseudomonas aeruginosa with ceftolozane\/tazobactam monotherapy","volume":"72","author":"Gentile","year":"2017","journal-title":"J Antimicrob Chemother"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.15","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s15010-016-0944-5","article-title":"Successful treatment of multidrug-resistant Pseudomonas aeruginosa breakthrough bacteremia with ceftolozane\/tazobactam","volume":"45","author":"Hern\u00e1ndez-Tejedor","year":"2017","journal-title":"Infection"},{"key":"2025082804383717000_2018.jan05_1.bcr-2017-223202.16","doi-asserted-by":"crossref","unstructured":"Kurtzhalts KE , Mergenhagen KA , Manohar A , et al . Successful treatment of multidrug-resistant Pseudomonas aeruginosa pubic symphysis osteomyelitis with ceftolozane\/tazobactam. 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