Clinical experience with ceftazidime-avibactam for the treatment of infections due to multidrug-resistant gram-negative bacteria other than carbapenem-resistant Enterobacterales

Antonio Cascio, Silvia Boni, Antonio Vena, Daniele Roberto Giacobbe, Francesco Giuseppe De Rosa, Marianna Meschiari, Silvia Corcione, Roberto Luzzati, Nadia Castaldo, Filippo Del Puente, Alessandra Oliva, Matteo Bassetti, Claudio Maria Mastroianni, Cristina Mussini, Chiara Sepulcri, Francesca Raumer, Sergio Carbonara, Annamaria Cattelan, Cristina Mussini, Alessandro Capone

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Experience in real clinical practice with ceftazidime-avibactam for the treatment of serious infections due to gram−negative bacteria (GNB) other than carbapenem-resistant Enterobacterales (CRE) is very limited. Methods: We carried out a retrospective multicenter study of patients hospitalized in 13 Italian hospitals who received ≤72 h of ceftazidime-avibactam for GNB other than CRE to assess the rates of clinical success, resistance development, and occurrence of adverse events. Results: Ceftazidime-avibactam was used to treat 41 patients with GNB infections other than CRE. Median age was 62 years and 68% of them were male. The main causative agents were P. aeruginosa (33/41; 80.5%) and extended spectrum beta lactamase (ESBL)-producing Enterobacterales (4/41, 9.8%). Four patients had polymicrobial infections. All strains were susceptible to ceftazidime-avibactam. The most common primary infection was nosocomial pneumonia (n = 20; 48.8%), primary bacteremia (n = 7; 17.1%), intra-abdominal infection (n = 4; 9.8%), and bone infection (n = 4; 9.8%). Ceftazidime-avibactam was mainly administered as a combination treatment (n = 33; 80.5%) and the median length of therapy was 13 days. Clinical success at the end of the follow-up period was 90.5%, and the only risk factor for treatment failure at multivariate analysis was receiving continuous renal replacement therapy during ceftazidime-avibactam. There was no association between clinical failures and type of primary infection, microbiological isolates, and monotherapy with ceftazidime-avibactam. Only one patient experienced recurrent infection 5 days after the end of treatment. Development of resistance to ceftazidime-avibactam was not detected in any case during the whole follow-up period. No adverse events related to ceftazidime-avibactam were observed in the study population. Conclusions: Ceftazidime-avibactam may be a valuable therapeutic option for serious infections due to GNB other than CRE.
Original languageEnglish
Pages (from-to)71-
Number of pages15
JournalAntibiotics
Volume9
Publication statusPublished - 2020

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Biochemistry
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'Clinical experience with ceftazidime-avibactam for the treatment of infections due to multidrug-resistant gram-negative bacteria other than carbapenem-resistant Enterobacterales'. Together they form a unique fingerprint.

  • Cite this

    Cascio, A., Boni, S., Vena, A., Giacobbe, D. R., De Rosa, F. G., Meschiari, M., Corcione, S., Luzzati, R., Castaldo, N., Del Puente, F., Oliva, A., Bassetti, M., Mastroianni, C. M., Mussini, C., Sepulcri, C., Raumer, F., Carbonara, S., Cattelan, A., Mussini, C., & Capone, A. (2020). Clinical experience with ceftazidime-avibactam for the treatment of infections due to multidrug-resistant gram-negative bacteria other than carbapenem-resistant Enterobacterales. Antibiotics, 9, 71-.