Combination Therapy with Ceftazidime-Avibactam and Amikacin for Multidrug-Resistant Pseudomonas aeruginosa Infection with Fulminant Myocarditis in a Younger Patient: A Case Report and Literature Review

 Fulminant myocarditis is a life-threatening disease among young patients. Pseudomonas aeruginosa is distributed in nature and is often spread as an opportunistic pathogen to cause hospital-acquired infections in patients with underlying diseases and low immunity.

 This report presented a case of a 28-year-old woman with fulminant myocarditis followed by P. aeruginosa infection. After hospitalization, she received veno-arterial extracorporeal membrane oxygenation (ECMO) and continuous renal replacement treatment (CRRT). Initially, piperacillin sodium tazobactam combined with amikacin was used for anti-infection therapy, which had a poor clinical effect. Subsequently, it was recommended to use ceftazidime-avibactam and amikacin for treatment. Finally, the infection index of the patient returned to normal.

 It is necessary to select correct and effective drugs according to etiology, considering the influence of ECMO and CRRT on the patient’s antimicrobial pharmacokinetics/pharmacodynamics (PK/PD). This case could provide a reference for safe and rational drug use in clinical practice.