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Efficacy of ceftazidime-avibactam in the treatment of infections due to Carbapenem-resistant Enterobacteriaceae.
BMC Infect Dis. 2019 Sep 04; 19(1):772.BI

Abstract

BACKGROUND

Carbapenem-resistant Enterobacteriaceae (CRE) represent an important global threat. The aim of this study is to describe the clinical course and outcomes of patients with CRE infections treated with ceftazidime-avibactam (CAZ-AVI) compared to patients treated with other agents.

METHODS

A retrospective cohort study of patients with established CRE infections from January 2017 until August 2018 was conducted. All patients who received CAZ-AVI and all cultures with carbapenem-resistant isolates were screened. We compared patients who received CAZ-AVI for CRE infections with patients who received other agents.

RESULTS

A total of 38 consecutive patients with CRE infections were identified. Age and baseline comorbidities were similar between the two groups. The median time from admission to isolation of CRE culture was 22.5 days in the CAZ-AVI group and 17 days in the comparative group (P = 0.7). The incidence of CRE bacteremia was similar between the two groups: 7 patients (70%) in the CAZ-AVI group and 15 patients (53.6%) in the comparative group (P = 0.47). The most common type of CRE infections in both groups was hospital acquired pneumonia (HAP). Klebsiella pneumoniae was the predominant pathogen in both groups. A carbapenemase gene was detected in 35 (92%) patients; the OXA-48 gene was the predominant gene identified in 28 (74%) isolates. Eight out of ten patients in the CAZ-AVI group and fifteen out of twenty-eight in the comparative group achieved clinical remission (P = 0.14). After thirty days, all-cause mortality was observed in five patients in the CAZ-AVI group and 16 patients in the comparative group, accounting for 50 and 57% respectively.

CONCLUSIONS

In patients with established OXA-48-type CRE infection, CAZ-AVI is a reasonable alternative to standard therapy. These findings need to be confirmed in prospective studies.

Authors+Show Affiliations

Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. balraddadi@kfshrc.edu.sa. Department of Medicine, University of Jeddah, Jeddah, Saudi Arabia. balraddadi@kfshrc.edu.sa.Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.Department of Pathology and Laboratory Medicine, Section of Clinical Microbiology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.Anti-infectives, Pfizer, Jeddah, Saudi Arabia.Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31484510

Citation

Alraddadi, Basem M., et al. "Efficacy of Ceftazidime-avibactam in the Treatment of Infections Due to Carbapenem-resistant Enterobacteriaceae." BMC Infectious Diseases, vol. 19, no. 1, 2019, p. 772.
Alraddadi BM, Saeedi M, Qutub M, et al. Efficacy of ceftazidime-avibactam in the treatment of infections due to Carbapenem-resistant Enterobacteriaceae. BMC Infect Dis. 2019;19(1):772.
Alraddadi, B. M., Saeedi, M., Qutub, M., Alshukairi, A., Hassanien, A., & Wali, G. (2019). Efficacy of ceftazidime-avibactam in the treatment of infections due to Carbapenem-resistant Enterobacteriaceae. BMC Infectious Diseases, 19(1), 772. https://doi.org/10.1186/s12879-019-4409-1
Alraddadi BM, et al. Efficacy of Ceftazidime-avibactam in the Treatment of Infections Due to Carbapenem-resistant Enterobacteriaceae. BMC Infect Dis. 2019 Sep 4;19(1):772. PubMed PMID: 31484510.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of ceftazidime-avibactam in the treatment of infections due to Carbapenem-resistant Enterobacteriaceae. AU - Alraddadi,Basem M, AU - Saeedi,Mohammed, AU - Qutub,Mohammed, AU - Alshukairi,Abeer, AU - Hassanien,Ashraf, AU - Wali,Ghassan, Y1 - 2019/09/04/ PY - 2019/05/27/received PY - 2019/08/25/accepted PY - 2019/9/6/entrez PY - 2019/9/6/pubmed PY - 2019/11/20/medline KW - Carbapenem-resistant Enterobacteriaceae KW - Ceftazidime-avibactam KW - Saudi Arabia SP - 772 EP - 772 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 19 IS - 1 N2 - BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) represent an important global threat. The aim of this study is to describe the clinical course and outcomes of patients with CRE infections treated with ceftazidime-avibactam (CAZ-AVI) compared to patients treated with other agents. METHODS: A retrospective cohort study of patients with established CRE infections from January 2017 until August 2018 was conducted. All patients who received CAZ-AVI and all cultures with carbapenem-resistant isolates were screened. We compared patients who received CAZ-AVI for CRE infections with patients who received other agents. RESULTS: A total of 38 consecutive patients with CRE infections were identified. Age and baseline comorbidities were similar between the two groups. The median time from admission to isolation of CRE culture was 22.5 days in the CAZ-AVI group and 17 days in the comparative group (P = 0.7). The incidence of CRE bacteremia was similar between the two groups: 7 patients (70%) in the CAZ-AVI group and 15 patients (53.6%) in the comparative group (P = 0.47). The most common type of CRE infections in both groups was hospital acquired pneumonia (HAP). Klebsiella pneumoniae was the predominant pathogen in both groups. A carbapenemase gene was detected in 35 (92%) patients; the OXA-48 gene was the predominant gene identified in 28 (74%) isolates. Eight out of ten patients in the CAZ-AVI group and fifteen out of twenty-eight in the comparative group achieved clinical remission (P = 0.14). After thirty days, all-cause mortality was observed in five patients in the CAZ-AVI group and 16 patients in the comparative group, accounting for 50 and 57% respectively. CONCLUSIONS: In patients with established OXA-48-type CRE infection, CAZ-AVI is a reasonable alternative to standard therapy. These findings need to be confirmed in prospective studies. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/31484510/Efficacy_of_ceftazidime_avibactam_in_the_treatment_of_infections_due_to_Carbapenem_resistant_Enterobacteriaceae_ DB - PRIME DP - Unbound Medicine ER -