Multi drug resistant (MDR) Pseudomonas aeruginosa and Extended-
Spectrum-lactamase (ESBL) Enterobacteriaceae are becoming an increasing difficult
clinical problem. Immediate resistance to some of the new antimicrobials such
as ceftolozane/tazobactam is unusual and is due to a variety of mechanisms such as
hyper-production of inactivating enzymes and gene mutation. In addition, previous
antimicrobial administration is a well-recognized risk factor to develop resistance.
We present a patient with a liver abscess where the organism was resistant to
ceftolozane/tazobactam resulting in a poor clinical outcome.
Keywords: Ceftolozane/Tazobactam, ESBL, gram negative bacteria, mutation, pseudomonas, resistance.
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