Background and importance Ceftazidima-avibactam is a recently commercialised antibiotic recommended for the treatment of infections caused by Gram-negative aerobic microorganisms, some of which have lately developed resistance to many antibacterials. Its importance in the current clinical practice stems from the fact that it can be used in patients with limited therapeutic options where other antibacterials are ineffective.
Aim and objectives To evaluate the clinical indications and causal microorganisms for which ceftazidima-avibactam was prescribed in a third-level hospital and to assess whether resolution of the infection was achieved.
Material and methods Observational, descriptive and retrospective study of all the patients that have received antibiotic treatment with ceftazidima-avibactam from July 2017 to April 2021.
To evaluate the indications and resolution, the medical history of the patients was reviewed. The laboratory database was also checked to identify the causal microorganisms. Variables studied were: patient demographics, prescribing units, isolated microorganism, diagnosis and motive of suspension.
Results Sixty-six patients were included in this study (62% men), with a median age of 63 (16–86) years. Twenty-eight of these patients were hospitalised in intensive care units (42%), 7 in Haematology (11%), 6 in General Surgery (9%), 6 in Vascular Surgery (9%) and the remaining patients in other different units (29%). During the period of study, 9 patients died (14%).
The main causal agents isolated were Klebsiella pneumoniae producing extended-spectrum ß-lactamase (ESBL) and carbapenemase in 19 patients (29%), Pseudomonas aeruginosa in 19 (29%, multiresistant in 16) and Enterobacter cloacae complex ESBL and carbapenemase in 12 (18%).
The infections for which the treatment has mainly been prescribed are bacteraemia in 23 patients (35%), surgical wound infection in 13 (20%), urinary tract infection in 10 (15%), intra-abdominal infection in 6 (9%) and pneumonia in 6 (9%).
Clinical resolution has been accomplished in 28 patients (42%) and microbiological resolution in 8 (12%). In 20 patients (30%), treatment has been suspended for de-escalation to a narrower-spectrum antibiotic. One patient (1.5%) was moved to another hospital, thus tracking was lost.
Conclusion and relevance Ceftazidima-avibactam achieved resolution of the infection in most patients. It was satisfactorily used to treat infections caused by resistant Gram-negative agents for which there were no other available options.
Conflict of interest No conflict of interest
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