Ceftazidime-avibactam and aztreonam as a therapeutic alternative in two episodes of bacteremia due to Stenotrophomonas maltophilia after allogeneic hematopoietic stem cell transplantation: case report.

Authors

Wilder Bolaños-Vargas, Cesar Copaja-Corzo, Ivan Fernandez Vertiz, Alfredo Wong-Chang, Miriam Rut Baldeon Laureano

Published in

Revista peruana de medicina experimental y salud publica. Volume 43. Issue 1. Pages 126-131. Mar 02, 2026. Epub Mar 02, 2026.

Abstract

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 ceftazidi-me-avibactam plus aztreonam can be useful against S. maltophilia infections in post-HSCT patients with contraindications for the use of TMP-SMX.

PMID:
42424293
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

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