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Serratia marcescens prosthesis infection successfully treated with meropenem after imipenem failure

A Lefort1, S Righi, F Jauréguy

  • 1Service de Maladies Infectieuses et Tropicales, Hôpital Necker, Université Paris V, 149 rue de Sèvres, 75743 Paris Cedex 15, France. aglefort@yahoo.com

The Journal of Infection
|July 26, 2005
PubMed

Insights

High-dose meropenem successfully treated a knee-prosthesis infection caused by multiresistant Serratia marcescens in an elderly patient. Meropenem may be a preferred treatment over imipenem/cilastatin for elderly patients with similar osteo-articular infections due to lower neurotoxicity.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Orthopedic Surgery

Background:

  • Osteo-articular infections pose significant challenges, particularly those caused by multidrug-resistant (MDR) Gram-negative bacilli.
  • Elderly patients present unique challenges in managing infections due to comorbidities and potential increased susceptibility to treatment side effects.

Observation:

  • A 78-year-old female patient experienced an early knee-prosthesis infection.
  • The causative agent was identified as multiresistant Serratia marcescens.
  • Initial treatment with imipenem/cilastatin combined with multiple surgical interventions proved unsuccessful.

Findings:

  • High-dose meropenem therapy led to successful resolution of the knee-prosthesis infection.
  • Meropenem demonstrated efficacy against the MDR Serratia marcescens.
  • The patient tolerated high-dose meropenem well, with no reported neurotoxicity.

Implications:

  • Meropenem may offer a safer and effective alternative to imipenem/cilastatin for treating osteo-articular infections in the elderly, especially those caused by MDR Gram-negative bacilli.
  • The lower neurotoxicity profile of meropenem is a significant advantage in this patient population.
  • This case highlights the importance of considering antibiotic choice and potential side effects in elderly patients with complex orthopedic infections.

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