RT Journal Article
T1 Ceftazidime-Avibactam as Salvage Therapy for Infections Caused by Carbapenem-Resistant Organisms
A1 Temkin, Elizabeth
A1 Torre-Cisneros, Julian
A1 Beovic, Bojana
A1 Benito, Natividad
A1 Giannella, Maddalena
A1 Gilarranz, Raul
A1 Jeremiah, Cameron
A1 Loeches, Belen
A1 Machuca, Isabel
A1 Jose Jimenez-Martin, Maria
A1 Antonio Martinez, Jose
A1 Mora-Rillo, Marta
A1 Navas, Enrique
A1 Osthoff, Michael
A1 Carlos Pozo, Juan
A1 Ramos Ramos, Juan Carlos
A1 Rodriguez, Marina
A1 Sanchez-Garcia, Miguel
A1 Viale, Pierluigi
A1 Wolff, Michel
A1 Carmeli, Yehuda
K1 Carbapenem resistance
K1 Case series
K1 Ceftazidime-avibactam
K1 Blood-stream infections
K1 Klebsiella-pneumoniae
AB Ceftazidime-avibactam (CAZ-AVI) is a recently approved beta-lactam-beta-lactamase inhibitor combination with the potential to treat serious infections caused by carbapenem-resistant organisms. Few patients with such infections were included in the CAZ-AVI clinical trials, and clinical experience is lacking. We present a case series of patients with infections caused by carbapenem-resistant Enterobacteriaceae (CRE) or Pseudomonas aeruginosa (CRPa) who were treated with CAZ-AVI salvage therapy on a compassionate-use basis. Physicians who had prescribed CAZ-AVI completed a case report form. We used descriptive statistics to summarize patient characteristics and treatment outcomes. We used the Wilcoxon rank sum test and Fisher's exact test to compare patients by treatment outcome. The sample included 36 patients infected with CRE and two with CRPa. The most common infections were intra-abdominal. Physicians categorized 60.5% of patients as having life-threatening infections. All but two patients received other antibiotics before CAZ-AVI, for a median of 13 days. The median duration of CAZ-AVI treatment was 16 days. Twenty-five patients (65.8%) concurrently received other antibiotics to which their pathogen was nonresistant in vitro. Twenty-eight patients (73.7%, 95% confidence interval [CI], 56.9 to 86.6%) experienced clinical and/or microbiological cure. Five patients (20.8%) with documented microbiological cure died, whereas 10 patients (71.4%) with no documented microbiological cure died (P = 0.01). In three-quarters of cases, CAZ-AVI (alone or combined with other antibiotics) cured infections caused by carbapenem-resistant organisms, 95% of which had failed previous therapy. Microbiological cure was associated with improved survival. CAZ-AVI shows promising clinical results for infections for which treatment options are limited.
PB American Society for Microbiology
SN 0066-4804
YR 2016
FD 2016-11-08
LK http://hdl.handle.net/10668/19007
UL http://hdl.handle.net/10668/19007
LA en
NO Temkin E, Torre-Cisneros J, Beovic B, Benito N, Giannella M, Gilarranz R, et al. Ceftazidime-Avibactam as Salvage Therapy for Infections Caused by Carbapenem-Resistant Organisms. Antimicrob Agents Chemother. 2017 Jan 24;61(2):e01964-16
NO This work was not supported by any external funding agency. Coauthors J.T.-C. andN.B. are funded by the Ministerio de Economía y Competitividad, Instituto de SaludCarlos III, cofinanced by the European Development Regional Fund (ERDF) “A way toachieve Europe,” Spanish Network for Research in Infectious Diseases (REIPI RD12/0015)
DS RISalud
RD Apr 11, 2025