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Revista de la OFIL

On-line version ISSN 1699-714XPrint version ISSN 1131-9429

Abstract

CALVO-GARCIA, A et al. Ceftazidime-avibactam: effectiveness and safety in the clinical practice. A third hospital level experience. Rev. OFIL·ILAPHAR [online]. 2022, vol.32, n.1, pp.57-62.  Epub Nov 21, 2022. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699-714x20220001000010.

Objectives:

Ceftazidime/avibactam (CZA) is a third generation cephalosporin and the first non-beta-lactam beta-lactamase inhibitor combination. The main outcome was to assess the effectiveness and safety of CZA in the clinical practice.

Methods:

It was a retrospective observational study. The inclusion criteria were age >18 years and receipt of >24 hours of CZA between January 2016 and October 2018. Variables studied included demographic, clinical, and treatment.

Results:

63 inpatients in treatment with CZA were included, 39 (61.9 %) were male and the mean (SD) age was 64.3 (15.8) years. Thirty-eight (60.3%) patients presented bacteremia and 28 (44.4%) were admitted in Intensive Care Unit (ICU). Klebsiella pneumoniae were isolated in 43 (68.3) patients, and OXA-48 carbapenemase in 51 (81.0%). Concomitant antibiotic was used in 40 (63.5%) patients. Mortality at 14 and 30 days were 6 (9.5%) and 4 (6.3%) patients, respectively.

Thirty-five (55.6%) patients reached microbiological cure and 47 (74.6%) clinical cure. Infection recurrence evaluated at 90 days was achieved in 23 (36.5%) patients. ICU admission and bacteremia showed decreased in clinical cure (p=0.023 and p=0.01, respectively). Only ICU admission had a diminution in microbiological cure (p=0.035) and bacteremia a higher recurrence evaluated at 90 days (p=0.003). Only 3 (4.8%) patients interrupted treatment because of the adverse events.

Conclusions:

ICU admission had demonstrated a microbiological and clinical cure decreasing. Recurrence evaluated a 90 days was statically significant higher in patients with bacteremia. CZA was a security antibiotic, with a very low incidence of treatment interruptions.

Keywords : Ceztazidime-avibactam; antibiotic resistance; enterobacteriaceae infections; nosocomial infections; carbapenemase-producing enterobacteriaceae; beta-lactamase; klebsiella pneumoniae.

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