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Clinical characteristics and prognosis of infections caused by OXA-48 carbapenemase-producing Enterobacteriaceae in patients treated with ceftazidime-avibactam.
Int J Antimicrob Agents. 2019 Apr; 53(4):520-524.IJ

Abstract

BACKGROUND

Ceftazidime-avibactam has in vitro activity against Gram-negative bacilli that produce Class A, C and some D β-lactamases, and has been successfully used in the treatment of infections caused by cephalosporin and carbapenem-resistant Enterobacteriaceae. However, actual experience in the treatment of OXA-48 carbapenemase-producing Enterobacteriaceae (CPE) is limited.

OBJECTIVE

To review the characteristics and prognosis of OXA-48 CPE infections treated with ceftazidime-avibactam since introduction of the drug to the current centre during the period October 2014 to December 2016.

METHODS

Retrospective assessment of episodes of infection caused by OXA-48 CPE treated with ceftazidime-avibactam, analysing data collected from infection diagnosis until 90 days after the end of treatment.

RESULTS

Twenty-four episodes were analysed. Ceftazidime-avibactam was given as the initial definitive treatment in 15 (62.5%) and as salvage therapy in nine (37.5%). Intraabdominal (seven, 29%), urinary (six, 25%) and respiratory (five, 21%) were the most common sources. The 30-day and 90-day mortality rates were 8.3% and 20.8%, respectively. Clinical cure at 30 days was achieved in 62.5% of episodes. Four (16.7%) patients had adverse events, two of them were related to impaired renal function. Among patients who finished the treatment with ceftazidime-avibactam, seven (35%) were diagnosed with infection recurrence within 90 days of the end of treatment.

CONCLUSIONS

From experience, ceftazidime-avibactam is an effective drug for treating infections due to OXA-48 CPE. From these results a better safety profile than the current best available therapy could be expected.

Authors+Show Affiliations

Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain. Electronic address: Cristinacalle10@hotmail.com.Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain.Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain.Department of Microbiology, Hospital Clinic of Barcelona, Barcelona, Spain.Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain.Department of Infectious Diseases, Hospital Clinic, Barcelona, University of Barcelona, IDIBAPS, Spain.Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain.Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain.Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain.Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain.Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain.Department of Infectious Diseases, Hospital Clinic, Barcelona, University of Barcelona, IDIBAPS, Spain.Department of Infectious Diseases, Hospital Clinic, Barcelona, University of Barcelona, IDIBAPS, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30471403

Citation

De la Calle, Cristina, et al. "Clinical Characteristics and Prognosis of Infections Caused By OXA-48 Carbapenemase-producing Enterobacteriaceae in Patients Treated With Ceftazidime-avibactam." International Journal of Antimicrobial Agents, vol. 53, no. 4, 2019, pp. 520-524.
De la Calle C, Rodríguez O, Morata L, et al. Clinical characteristics and prognosis of infections caused by OXA-48 carbapenemase-producing Enterobacteriaceae in patients treated with ceftazidime-avibactam. Int J Antimicrob Agents. 2019;53(4):520-524.
De la Calle, C., Rodríguez, O., Morata, L., Marco, F., Cardozo, C., García-Vidal, C., Río, A. D., Feher, C., Pellicé, M., Puerta-Alcalde, P., Mensa, J., Soriano, A., & Martínez, J. A. (2019). Clinical characteristics and prognosis of infections caused by OXA-48 carbapenemase-producing Enterobacteriaceae in patients treated with ceftazidime-avibactam. International Journal of Antimicrobial Agents, 53(4), 520-524. https://doi.org/10.1016/j.ijantimicag.2018.11.015
De la Calle C, et al. Clinical Characteristics and Prognosis of Infections Caused By OXA-48 Carbapenemase-producing Enterobacteriaceae in Patients Treated With Ceftazidime-avibactam. Int J Antimicrob Agents. 2019;53(4):520-524. PubMed PMID: 30471403.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics and prognosis of infections caused by OXA-48 carbapenemase-producing Enterobacteriaceae in patients treated with ceftazidime-avibactam. AU - De la Calle,Cristina, AU - Rodríguez,Olga, AU - Morata,Laura, AU - Marco,Francesc, AU - Cardozo,Celia, AU - García-Vidal,Carolina, AU - Río,Ana Del, AU - Feher,Csaba, AU - Pellicé,Martina, AU - Puerta-Alcalde,Pedro, AU - Mensa,Josep, AU - Soriano,Alex, AU - Martínez,Jose Antonio, Y1 - 2018/11/22/ PY - 2017/12/06/received PY - 2018/11/09/revised PY - 2018/11/17/accepted PY - 2018/11/25/pubmed PY - 2019/8/14/medline PY - 2018/11/25/entrez KW - Adverse events KW - Carbapenemase KW - Ceftazidima-avibactam KW - Enterobacteriaceae KW - Mortality KW - Treatment SP - 520 EP - 524 JF - International journal of antimicrobial agents JO - Int. J. Antimicrob. Agents VL - 53 IS - 4 N2 - BACKGROUND: Ceftazidime-avibactam has in vitro activity against Gram-negative bacilli that produce Class A, C and some D β-lactamases, and has been successfully used in the treatment of infections caused by cephalosporin and carbapenem-resistant Enterobacteriaceae. However, actual experience in the treatment of OXA-48 carbapenemase-producing Enterobacteriaceae (CPE) is limited. OBJECTIVE: To review the characteristics and prognosis of OXA-48 CPE infections treated with ceftazidime-avibactam since introduction of the drug to the current centre during the period October 2014 to December 2016. METHODS: Retrospective assessment of episodes of infection caused by OXA-48 CPE treated with ceftazidime-avibactam, analysing data collected from infection diagnosis until 90 days after the end of treatment. RESULTS: Twenty-four episodes were analysed. Ceftazidime-avibactam was given as the initial definitive treatment in 15 (62.5%) and as salvage therapy in nine (37.5%). Intraabdominal (seven, 29%), urinary (six, 25%) and respiratory (five, 21%) were the most common sources. The 30-day and 90-day mortality rates were 8.3% and 20.8%, respectively. Clinical cure at 30 days was achieved in 62.5% of episodes. Four (16.7%) patients had adverse events, two of them were related to impaired renal function. Among patients who finished the treatment with ceftazidime-avibactam, seven (35%) were diagnosed with infection recurrence within 90 days of the end of treatment. CONCLUSIONS: From experience, ceftazidime-avibactam is an effective drug for treating infections due to OXA-48 CPE. From these results a better safety profile than the current best available therapy could be expected. SN - 1872-7913 UR - https://www.unboundmedicine.com/medline/citation/30471403/Clinical_characteristics_and_prognosis_of_infections_caused_by_OXA_48_carbapenemase_producing_Enterobacteriaceae_in_patients_treated_with_ceftazidime_avibactam_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-8579(18)30340-6 DB - PRIME DP - Unbound Medicine ER -