A Novel Combination Regimen for the Treatment of Refractory Bacteremia Due to Multidrug-Resistant Pseudomonas Aeruginosa in a Liver Transplant Recipient

P>Both bacteremia and biliary cast syndrome are serious post -transplant complications in liver transplant recipients. In the setting of increasing drug resistance in the current era, management of infections caused by multidrug-resistant( MDR) bacteria has proven challenging. We present a case of a liver transplant recipient who developed biliary cast syndrome and intractable MDR Pseudomonas bacteremia that failed to resolve with conventional antimicrobial therapy and which was finally controlled by a novel combination regimen of colistimethate, doripenem, and tobramycin. Future studies validating the clinical efficacy of this combination strategy are warranted