Ceftazidime-avibactam to treat life-threatening infections by carbapenem-resistant pathogens in critically ill mechanically ventilated patients
dc.creator | Tsolaki V., Mantzarlis K., Mpakalis A., Malli E., Tsimpoukas F., Tsirogianni A., Papagiannitsis C., Zygoulis P., Papadonta M.-E., Petinaki E., Makris D., Zakynthinos E. | en |
dc.date.accessioned | 2023-01-31T10:17:15Z | |
dc.date.available | 2023-01-31T10:17:15Z | |
dc.date.issued | 2020 | |
dc.identifier | 10.1128/AAC.02320-19 | |
dc.identifier.issn | 00664804 | |
dc.identifier.uri | http://hdl.handle.net/11615/80082 | |
dc.description.abstract | Data on the effectiveness of ceftazidime-avibactam (CAZ-AVI) in critically ill, mechanically ventilated patients are limited. The present retrospective observational cohort study, which was conducted in two general intensive care units (ICUs) in central Greece, compared critically ill, mechanically ventilated patients suffering from carbapenem-resistant Enterobacteriaceae (CRE) infections receiving CAZ-AVI to patients who received appropriate available antibiotic therapy. Clinical and microbiological outcomes and safety issues were evaluated. A secondary analysis in patients with bloodstream infections (BSIs) was conducted. Forty-one patients that received CAZ-AVI (the CAZ-AVI group) were compared to 36 patients that received antibiotics other than CAZ-AVI (the control group). There was a significant improvement in the Sequential Organ Failure Assessment (SOFA) score on days 4 and 10 in the CAZ-AVI group compared to that in the control group (P = 0.006, and P = 0.003, respectively). Microbiological eradication was accomplished in 33/35 (94.3%) patients in the CAZ-AVI group and 21/31 (67.7%) patients in the control group (P = 0.021), and clinical cure was observed in 33/41 (80.5%) versus 19/36 (52.8%) patients (P = 0.010), respectively. The results were similar in the BSI subgroups for both outcomes (P = 0.038 and P = 0.014, respectively). The 28-day survival was 85.4% in the CAZ-AVI group and 61.1% in the control group (log-rank test = 0.035), while there were 2 and 12 relapses in the CAZ-AVI and control groups, respectively (P = 0.042). A CAZ-AVI-containing regime was an independent predictor of survival and clinical cure (odds ratio [OR] = 5.575 and P = 0.012 and OR = 5.125 and P = 0.004, respectively), as was illness severity. No significant side effects were recorded. In conclusion, a CAZ-AVI-containing regime was more effective than other available antibiotic agents for the treatment of CRE infections in the high-risk, mechanically ventilated ICU population evaluated. Copyright © 2020 American Society for Microbiology. All Rights Reserved. | en |
dc.language.iso | en | en |
dc.source | Antimicrobial Agents and Chemotherapy | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85079904173&doi=10.1128%2fAAC.02320-19&partnerID=40&md5=f11ce1daa08cb3eb3ea61530de8f6ab5 | |
dc.subject | antibiotic agent | en |
dc.subject | avibactam plus ceftazidime | en |
dc.subject | colistin | en |
dc.subject | creatinine | en |
dc.subject | tigecycline | en |
dc.subject | avibactam, ceftazidime drug combination | en |
dc.subject | azabicyclo derivative | en |
dc.subject | carbapenem derivative | en |
dc.subject | ceftazidime | en |
dc.subject | acute kidney failure | en |
dc.subject | adult | en |
dc.subject | aged | en |
dc.subject | antibiotic sensitivity | en |
dc.subject | antibiotic therapy | en |
dc.subject | APACHE | en |
dc.subject | Article | en |
dc.subject | bacterium isolate | en |
dc.subject | bloodstream infection | en |
dc.subject | carbapenem-resistant Enterobacteriaceae | en |
dc.subject | Charlson Comorbidity Index | en |
dc.subject | clinical assessment | en |
dc.subject | clinical outcome | en |
dc.subject | cohort analysis | en |
dc.subject | comparative study | en |
dc.subject | controlled study | en |
dc.subject | creatinine blood level | en |
dc.subject | creatinine clearance | en |
dc.subject | critically ill patient | en |
dc.subject | drug efficacy | en |
dc.subject | drug safety | en |
dc.subject | Enterobacteriaceae infection | en |
dc.subject | female | en |
dc.subject | Greece | en |
dc.subject | human | en |
dc.subject | intensive care unit | en |
dc.subject | length of stay | en |
dc.subject | loading drug dose | en |
dc.subject | major clinical study | en |
dc.subject | male | en |
dc.subject | middle aged | en |
dc.subject | monotherapy | en |
dc.subject | multiple organ failure | en |
dc.subject | observational study | en |
dc.subject | priority journal | en |
dc.subject | retrospective study | en |
dc.subject | Sequential Organ Failure Assessment Score | en |
dc.subject | shock | en |
dc.subject | side effect | en |
dc.subject | survival prediction | en |
dc.subject | survival rate | en |
dc.subject | ventilated patient | en |
dc.subject | ventilator associated pneumonia | en |
dc.subject | artificial ventilation | en |
dc.subject | critical illness | en |
dc.subject | drug combination | en |
dc.subject | drug effect | en |
dc.subject | Enterobacteriaceae | en |
dc.subject | Enterobacteriaceae infection | en |
dc.subject | microbial sensitivity test | en |
dc.subject | pathogenicity | en |
dc.subject | Aged | en |
dc.subject | Azabicyclo Compounds | en |
dc.subject | Carbapenems | en |
dc.subject | Ceftazidime | en |
dc.subject | Critical Illness | en |
dc.subject | Drug Combinations | en |
dc.subject | Enterobacteriaceae | en |
dc.subject | Enterobacteriaceae Infections | en |
dc.subject | Female | en |
dc.subject | Humans | en |
dc.subject | Male | en |
dc.subject | Microbial Sensitivity Tests | en |
dc.subject | Middle Aged | en |
dc.subject | Respiration, Artificial | en |
dc.subject | Retrospective Studies | en |
dc.subject | American Society for Microbiology | en |
dc.title | Ceftazidime-avibactam to treat life-threatening infections by carbapenem-resistant pathogens in critically ill mechanically ventilated patients | en |
dc.type | journalArticle | en |
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