Antibacterials
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Lack of efficacy: case report A retrospective analysis of 4 pateints conducted between January 2005–December 2017 described a 77-year-old man, who exhibited lack of efficacy during treatment with amoxicillin/clavulanic-acid, cotrimoxazole, piperacillin/tazobactam and vancomycin for pulmonary nocardiosis [not all routes stated; dosages not stated]. The man, who had a history of chronic obstructive pulmonary disease (COPD) and bronchiectasis, was admitted to the emergency room due to dysponea, fever and non-productive cough. A chest radiograph demonstrated increased cardiothoracic ratio with nodular opacities predominant in the lower lung fields. It was assumed that he had COPD exacerbation due to acute tracheobronchitis. Then, he started receiving amoxicillin/clavulanic-acid [amoxicillin-clavulanate] for 10 days; however, no clinical resolution of symptoms was noted. His fever persisted. Thus, amoxicillin/clavulanic-acid was changed to piperacillin/tazobactam and vancomycin. Thorax CT scan revealed bilateral consolidations with air bronchogram. It suggested nosocomial bilateral pneumonia. Blood cultures showed positive result for Nocardia spp. He was diagnosed with pulmonary nocardiosis. Subsequently, IV cotrimoxazole [trimethoprim/sulfamethoxazole] was aded to his regimen. However, he developed septic shock with multiorgan dysfunction, refractory to all the therapeutic regimen, and he died. Oliveira Cabrita BM, et al. Pulmonary nocardiosis: A Single Center Study. Respiratory Medicine Case Reports 31: Jan 2020. Available from: URL: http://doi.org/10.1016/ 803507056 j.rmcr.2020.101175
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Reactions 17 Oct 2020 No. 1826
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