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Clinical experience with ceftazidime/avibactam for treatment of antibiotic-resistant organisms other than Klebsiella pneumoniae.
Int J Antimicrob Agents 2018; 51(4):629-635IJ

Abstract

BACKGROUND

Ceftazidime/avibactam is a newly approved β-lactam/β-lactamase inhibitor combination with activity against antibiotic-resistant Gram-negative organisms, including many carbapenem-resistant strains. Although this agent may offer a promising treatment option for serious infections with limited alternatives available, clinical experience with ceftazidime/avibactam in treatment of infections caused by multidrug-resistant Gram-negative organisms other than Klebsiella pneumoniae is limited.

METHODS

A retrospective case series was performed to evaluate patients treated with ceftazidime/avibactam for infections caused by organisms other than K. pneumoniae at our institution over a 1-year period. Patients aged at least 18 years who received at least one dose of ceftazidime/avibactam were eligible for inclusion. Clinical and microbiological data were collected, and investigators assessed adverse effects, microbiological cure, clinical success, and 30-day in-hospital mortality following completion of ceftazidime/avibactam therapy.

RESULTS

Ten patients were included. The most common index infection was pneumonia (n = 6/13, 46%) and the most frequently isolated organism was Pseudomonas aeruginosa (n = 8/21, 38%). Fifty percent of patients received ceftazidime/avibactam as monotherapy. Microbiological cure was achieved in 67% (n = 6/9) of patients and 70% (n = 7/10) of patients met criteria for clinical success. The 30-day in-hospital mortality rate was 30%. No patients experienced adverse events because of ceftazidime/avibactam therapy.

CONCLUSIONS

For infections caused by antibiotic-resistant Gram-negative organisms other than K. pneumoniae, clinical and microbiological success rates for patients treated with ceftazidime/avibactam were similar to those that have been reported for K. pneumoniae. Ceftazidime/avibactam appears to be a promising treatment option for infections caused by a variety of resistant Gram-negative organisms when limited alternatives exist.

Authors+Show Affiliations

Department of Pharmacy Services, Medical University of South Carolina, Charleston, SC, USA; Medical University of South Carolina College of Pharmacy, Charleston, SC, USA. Electronic address: Barbara.Santevecchi@carolinashealthcare.org.Department of Pharmacy Services, Medical University of South Carolina, Charleston, SC, USA; Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, USA.Department of Pharmacy Services, Medical University of South Carolina, Charleston, SC, USA; Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29408227

Citation

Santevecchi, Barbara A., et al. "Clinical Experience With Ceftazidime/avibactam for Treatment of Antibiotic-resistant Organisms Other Than Klebsiella Pneumoniae." International Journal of Antimicrobial Agents, vol. 51, no. 4, 2018, pp. 629-635.
Santevecchi BA, Smith TT, MacVane SH. Clinical experience with ceftazidime/avibactam for treatment of antibiotic-resistant organisms other than Klebsiella pneumoniae. Int J Antimicrob Agents. 2018;51(4):629-635.
Santevecchi, B. A., Smith, T. T., & MacVane, S. H. (2018). Clinical experience with ceftazidime/avibactam for treatment of antibiotic-resistant organisms other than Klebsiella pneumoniae. International Journal of Antimicrobial Agents, 51(4), pp. 629-635. doi:10.1016/j.ijantimicag.2018.01.016.
Santevecchi BA, Smith TT, MacVane SH. Clinical Experience With Ceftazidime/avibactam for Treatment of Antibiotic-resistant Organisms Other Than Klebsiella Pneumoniae. Int J Antimicrob Agents. 2018;51(4):629-635. PubMed PMID: 29408227.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical experience with ceftazidime/avibactam for treatment of antibiotic-resistant organisms other than Klebsiella pneumoniae. AU - Santevecchi,Barbara A, AU - Smith,Tiffeny T, AU - MacVane,Shawn H, Y1 - 2018/02/02/ PY - 2017/11/01/received PY - 2018/01/05/revised PY - 2018/01/20/accepted PY - 2018/2/7/pubmed PY - 2018/8/29/medline PY - 2018/2/7/entrez KW - Antibiotic resistance KW - Carbapenem-resistant Enterobacteriaceae KW - Ceftazidime/avibactam KW - Gram-negative organisms KW - Pseudomonas aeruginosa SP - 629 EP - 635 JF - International journal of antimicrobial agents JO - Int. J. Antimicrob. Agents VL - 51 IS - 4 N2 - BACKGROUND: Ceftazidime/avibactam is a newly approved β-lactam/β-lactamase inhibitor combination with activity against antibiotic-resistant Gram-negative organisms, including many carbapenem-resistant strains. Although this agent may offer a promising treatment option for serious infections with limited alternatives available, clinical experience with ceftazidime/avibactam in treatment of infections caused by multidrug-resistant Gram-negative organisms other than Klebsiella pneumoniae is limited. METHODS: A retrospective case series was performed to evaluate patients treated with ceftazidime/avibactam for infections caused by organisms other than K. pneumoniae at our institution over a 1-year period. Patients aged at least 18 years who received at least one dose of ceftazidime/avibactam were eligible for inclusion. Clinical and microbiological data were collected, and investigators assessed adverse effects, microbiological cure, clinical success, and 30-day in-hospital mortality following completion of ceftazidime/avibactam therapy. RESULTS: Ten patients were included. The most common index infection was pneumonia (n = 6/13, 46%) and the most frequently isolated organism was Pseudomonas aeruginosa (n = 8/21, 38%). Fifty percent of patients received ceftazidime/avibactam as monotherapy. Microbiological cure was achieved in 67% (n = 6/9) of patients and 70% (n = 7/10) of patients met criteria for clinical success. The 30-day in-hospital mortality rate was 30%. No patients experienced adverse events because of ceftazidime/avibactam therapy. CONCLUSIONS: For infections caused by antibiotic-resistant Gram-negative organisms other than K. pneumoniae, clinical and microbiological success rates for patients treated with ceftazidime/avibactam were similar to those that have been reported for K. pneumoniae. Ceftazidime/avibactam appears to be a promising treatment option for infections caused by a variety of resistant Gram-negative organisms when limited alternatives exist. SN - 1872-7913 UR - https://www.unboundmedicine.com/medline/citation/29408227/Clinical_experience_with_ceftazidime/avibactam_for_treatment_of_antibiotic_resistant_organisms_other_than_Klebsiella_pneumoniae_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-8579(18)30019-0 DB - PRIME DP - Unbound Medicine ER -