1. Multicentre study of ceftazidime/avibactam for Gram-negative bacteria infections in critically ill patients.
- Author
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Balandín B, Ballesteros D, Pintado V, Soriano-Cuesta C, Cid-Tovar I, Sancho-González M, Pérez-Pedrero MJ, Chicot M, Asensio-Martín MJ, Silva JA, de Luna RR, Gesso CM, Rodríguez-Serrano DA, Martínez-Sagasti F, and Royuela A
- Subjects
- Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Azabicyclo Compounds therapeutic use, Critical Illness, Drug Combinations, Drug Resistance, Multiple, Bacterial, Gram-Negative Bacteria, Humans, Microbial Sensitivity Tests, Retrospective Studies, Ceftazidime therapeutic use, Gram-Negative Bacterial Infections drug therapy, Gram-Negative Bacterial Infections microbiology
- Abstract
This study aimed to assess the efficacy of ceftazidime/avibactam (C/A) in the treatment of infections due to Gram-negative bacteria (GNB) in critically ill patients. A multicentre, retrospective, observational study was conducted in critically ill patients receiving C/A for GNB infections. We evaluated demographic data, localisation and severity of infection, clinical and microbiological outcomes, and mortality. A total of 68 patients received C/A for serious GNB infections. The main infections were respiratory (33.8%), intra-abdominal (22.1%) and urinary tract infections (10.3%); bacteraemia was found in 22 cases (32.4%). Most infections were complicated by septic shock (58.8%) or sepsis (36.8%) and most of them required life-supporting therapies. Enterobacterales (79.4%) and Pseudomonas aeruginosa (19.1%) were the most frequently isolated bacteria; 84.2% of isolates were carbapenem-resistant. Thirty-four patients (50.0%) received C/A in combination with other antimicrobials. Fifty patients (73.5%) presented a favourable clinical response. Microbiological eradication was documented in 25 cases (36.8%). No significant differences were found in clinical response between patients treated with monotherapy or combined therapy (79.4% vs. 67.6%; P = 0.27). Overall intensive care unit (ICU) mortality was 41.2%. Univariate analysis showed that 30-day all-cause mortality was significantly (P < 0.05) associated with bacteraemia, previous corticosteroid use and the need of life-supporting therapies. C/A appears to be an effective therapy for severe infections due to GNB, including carbapenem-resistant isolates, in critically ill patients. C/A combination therapy was not associated with a higher clinical response. Mortality correlated significantly with the presence of bacteraemia, previous corticosteroid use and the need for life-supporting therapies., Competing Interests: Declaration of Competing Interests None declared., (Copyright © 2022 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.)
- Published
- 2022
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