Cure of Limb-Threatening XDR Pseudomonas aeruginosa Infection: Combining Genome Sequencing, Therapeutic Drug Level Monitoring, and Surgical Debridement

Shanti Narayanasamy, Roger L. Nation, Andrew A. Mahony, M. Lindsay Grayson, Jason C. Kwong, Norelle L. Sherry, Sharmila Khumra, Andrew G. Ellis, Albert G. Frauman, Natasha E. Holmes

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3 Citations (Scopus)


We describe a case of limb-threatening osteomyelitis and metalware infection with carbapenemase-producing extensively drug-resistant Pseudomonas aeruginosa successfully cured with aggressive surgical debridement and combined intravenous fosfomycin and colistin. Real-time therapeutic drug monitoring was used to maximize probability of efficacy and minimize potential for toxicity.

Original languageEnglish
Article numberofaa572
Number of pages6
JournalOpen Forum Infectious Diseases
Issue number1
Publication statusPublished - 1 Jan 2021


  • colistin
  • fosfomycin
  • osteomyelitis
  • therapeutic drug monitoring
  • XDR gram-negative

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