CEFTAZIDIME-AVIBACTAM AND AZTREONAM AS A THER APEUTIC ALTERNATIVE IN TWO EPISODES OF BACTEREMIA DUE TO Stenotrophomonas maltophilia AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TR ANSPLANTATION: CASE REPORT

Bolaños-Vargas W.; Copaja-Corzo C.; Vertiz I.F.; Wong-Chang A.; Laureano M.R.B. · Revista Peruana de Medicina Experimental y Salud Publica (2026) · DOI: 10.17843/rpmesp.2026.431.15393

Resumen

Infection due to Stenotrophomonas maltophilia represents a therapeutic challenge in immunocompromised patients, especially during hematopoietic recovery after hematopoietic stem cell transplantation (HSCT). The use of trimethoprim-sulfamethoxazole (TMP-SMX), the first-line antimicrobial, is contraindicated due to its hematological toxicity. We present the case of a patient undergoing haploidentical HSCT who developed two episodes of bacteremia due to S. maltophilia on days +20 and +49. Given the contraindication of TMP-SMX due to severe myelosuppression, the combination of ceftazidime-avibactam and aztreonam was used as an alternative treatment, achieving clinical resolution in both episodes. The patient remained stable until day +100; however, he experienced graft failure and died on day +107 due to infection with Pseudomonas aeruginosa producing VIM-type carbapenemase. This case shows that the use of ceftazidime-avibactam plus aztreonam can be useful against S. maltophilia infections in post-HSCT patients with contraindications for the use of TMP-SMX.

Instituciones: Universidad San Ignacio de Loyola