Safety and Efficacy Profile of CSE-1034 as a Prolonged De-escalation Therapy in Prosthetic Joint Infection: A Case Report

Abstract

Background: Although rare, infection is considered to be most dreadful of the prosthetic related complications resulting in repeated surgical intervention, extended hospitalization or sometimes in loss of implant or permanent disability if not treated promptly. Poor treatment outcome associated with prosthetic joint infections (PJIs) could be partly attributed to rise in anti-microbial resistance among the causative agents. Case Presentation: This is a first reported case of ceftriaxone + sulbactam + ethylenediaminetetraacetic acid (CSE 1034) being used as an de-escalation therapy for more than 24 days with good safety and efficacy outcome in a 78 year male patient with PJI associated with hip replacement surgery, treated initially with meropenem and colistin followed by prolonged de-escalation therapy (24 days). Conclusions: In clinically complicated cases of deep infections where prolonged use of last resort antibiotics is used, CSE-1034 can be considered as a safe, efficacious and economical de-escalating antibiotic to complete the treatment course and prevent recurrence of infection, especially in PJI.