Abstract
A 77-year-old man had undergone left-lobe liver resection and a choledochojejunostomy six years previously, and thereafter he suffered from a postoperative relapse of cholangitis. He was admitted to our hospital due to liver abscesses and bacteremia caused by multidrug-resistant Pseudomonas aeruginosa. Empirical treatment with piperacillin/tazobactam was started, and the patient initially recovered. However, he developed a second case of sepsis caused by piperacillin/tazobactam-resistant P. aeruginosa bacteremia originating from a new liver abscess. We changed the piperacillin/tazobactam to colistin and flomoxef and continued the two antibiotics for one month. During the antibiotic therapy, the patient successfully underwent bile duct stent placement.
MeSH terms
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Aged
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Anti-Bacterial Agents / administration & dosage
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Anti-Bacterial Agents / adverse effects
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Anti-Bacterial Agents / therapeutic use
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Bacteremia / drug therapy
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Cephalosporins / therapeutic use
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Cholangitis / complications
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Cholangitis / therapy
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Colistin / administration & dosage
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Colistin / adverse effects
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Colistin / therapeutic use*
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Drug Resistance, Multiple, Bacterial
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Humans
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Kidney / drug effects
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Liver Abscess, Pyogenic / drug therapy*
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Liver Abscess, Pyogenic / etiology*
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Male
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Microbial Sensitivity Tests
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Penicillanic Acid / analogs & derivatives
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Penicillanic Acid / therapeutic use
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Piperacillin / therapeutic use
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Piperacillin, Tazobactam Drug Combination
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Pseudomonas Infections / drug therapy*
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Pseudomonas Infections / etiology*
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Pseudomonas aeruginosa* / drug effects
Substances
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Anti-Bacterial Agents
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Cephalosporins
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Piperacillin, Tazobactam Drug Combination
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Penicillanic Acid
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flomoxef
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Piperacillin
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Colistin