dc.creator | Karaiskos I., ikaraiskos@hygeia.gr, Daikos G.L., Gkoufa A., Adamis G., Stefos A., Symbardi S., Chrysos G., Filiou E., Basoulis D., Mouloudi E., Galani L., Akinosoglou K., Arvaniti K., Masgala A., Petraki M., Papadimitriou E., Galani I., Poulakou G., Routsi C., Giamarellou H. | en |
dc.date.accessioned | 2023-01-31T08:30:53Z | |
dc.date.available | 2023-01-31T08:30:53Z | |
dc.date.issued | 2021 | |
dc.identifier | 10.1093/jac/dkaa503 | |
dc.identifier.issn | 03057453 | |
dc.identifier.uri | http://hdl.handle.net/11615/74363 | |
dc.description.abstract | Background: Infections caused by KPC-producing Klebsiella pneumoniae (Kp) are associated with high mortality. Therefore, new treatment options are urgently required. Objectives: To assess the outcomes and predictors of mortality in patients with KPC-or OXA-48-Kp infections treated with ceftazidime/avibactam with an emphasis on KPC-Kp bloodstream infections (BSIs). Methods: A multicentre prospective observational study was conducted between January 2018 and March 2019. Patients with KPC-or OXA-48-Kp infections treated with ceftazidime/avibactam were included in the analysis. The subgroup of patients with KPC-Kp BSIs treated with ceftazidime/avibactam was matched by propensity score with a cohort of patients whose KPC-Kp BSIs had been treated with agents other than ceftazidime/avibactam with in vitro activity. Results: One hundred and forty-seven patients were identified; 140 were infected with KPC producers and 7 with OXA-48 producers. For targeted therapy, 68 (46.3%) patients received monotherapy with ceftazidime/avibactam and 79 (53.7%) patients received ceftazidime/avibactam in combination with at least another active agent. The 14 and 28 day mortality rates were 9% and 20%, respectively. The 28 day mortality among the 71 patients with KPC-Kp BSIs treated with ceftazidime/avibactam was significantly lower than that observed in the 71 matched patients, whose KPC-Kp BSIs had been treated with agents other than ceftazidime/avibactam (18.3% versus 40.8%; P = 0.005). In the Cox proportional hazards model, ultimately fatal disease, rapidly fatal disease and Charlson comorbidity index ≥2 were independent predictors of death, whereas treatment with ceftazidime/avibactam-containing regimens was the only independent predictor of survival. Conclusions: Ceftazidime/avibactam appears to be an effective treatment against serious infections caused by KPC-Kp. © 2021 The Author(s). | en |
dc.language.iso | en | en |
dc.source | Journal of Antimicrobial Chemotherapy | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85102098708&doi=10.1093%2fjac%2fdkaa503&partnerID=40&md5=7d461f1a531f20ff6f1402fb571591a9 | |
dc.subject | amikacin | en |
dc.subject | aminoglycoside | en |
dc.subject | avibactam plus ceftazidime | en |
dc.subject | carbapenemase | en |
dc.subject | cephalosporin derivative | en |
dc.subject | ciprofloxacin | en |
dc.subject | colistin | en |
dc.subject | cotrimoxazole | en |
dc.subject | creatinine | en |
dc.subject | fosfomycin | en |
dc.subject | gentamicin | en |
dc.subject | meropenem | en |
dc.subject | penicillin derivative | en |
dc.subject | tigecycline | en |
dc.subject | antiinfective agent | en |
dc.subject | avibactam | en |
dc.subject | azabicyclo derivative | en |
dc.subject | bacterial protein | en |
dc.subject | beta lactamase | en |
dc.subject | carbapenemase | en |
dc.subject | ceftazidime | en |
dc.subject | abdominal infection | en |
dc.subject | adult | en |
dc.subject | antibiotic therapy | en |
dc.subject | Article | en |
dc.subject | bacterium identification | en |
dc.subject | bloodstream infection | en |
dc.subject | carbapenemase producing Enterobacteriaceae | en |
dc.subject | catheter infection | en |
dc.subject | cause of death | en |
dc.subject | Charlson Comorbidity Index | en |
dc.subject | clinical assessment | en |
dc.subject | clinical evaluation | en |
dc.subject | cohort analysis | en |
dc.subject | controlled study | en |
dc.subject | drug efficacy | en |
dc.subject | fatality | en |
dc.subject | female | en |
dc.subject | human | en |
dc.subject | in vitro study | en |
dc.subject | Klebsiella pneumoniae infection | en |
dc.subject | loading drug dose | en |
dc.subject | major clinical study | en |
dc.subject | male | en |
dc.subject | molecularly targeted therapy | en |
dc.subject | monotherapy | en |
dc.subject | mortality rate | en |
dc.subject | multicenter study | en |
dc.subject | observational study | en |
dc.subject | outcome assessment | en |
dc.subject | personal experience | en |
dc.subject | propensity score | en |
dc.subject | prospective study | en |
dc.subject | sepsis | en |
dc.subject | septic shock | en |
dc.subject | single drug dose | en |
dc.subject | skin infection | en |
dc.subject | survival rate | en |
dc.subject | therapy effect | en |
dc.subject | urinary tract infection | en |
dc.subject | drug combination | en |
dc.subject | Klebsiella infection | en |
dc.subject | Klebsiella pneumoniae | en |
dc.subject | microbial sensitivity test | en |
dc.subject | register | en |
dc.subject | Anti-Bacterial Agents | en |
dc.subject | Azabicyclo Compounds | en |
dc.subject | Bacterial Proteins | en |
dc.subject | beta-Lactamases | en |
dc.subject | Ceftazidime | en |
dc.subject | Drug Combinations | en |
dc.subject | Humans | en |
dc.subject | Klebsiella Infections | en |
dc.subject | Klebsiella pneumoniae | en |
dc.subject | Microbial Sensitivity Tests | en |
dc.subject | Registries | en |
dc.subject | Oxford University Press | en |
dc.title | Ceftazidime/avibactam in the era of carbapenemase-producing Klebsiella pneumoniae: Experience from a national registry study | en |
dc.type | journalArticle | en |