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Efficacy of ceftazidime-avibactam in the treatment of carbapenem-resistant Klebsiella pneumoniae infections: Focus on solid organ transplantation recipients.
Hu, Juan; Zha, Lei; Yu, Yong-Wei; Su, Qun; Fang, Xue-Ling; Ji, Jin-Ru; Shen, Ping; Chen, Yun-Bo; Zheng, Xia; Xiao, Yong-Hong.
Afiliação
  • Hu J; Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Zha L; Department of Respiratory Medicine, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, China.
  • Yu YW; Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Su Q; Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Fang XL; Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Ji JR; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Chi
  • Shen P; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Chi
  • Chen YB; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Chi
  • Zheng X; Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. Electronic address: zxicu@zju.edu.cn.
  • Xiao YH; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Chi
Int J Antimicrob Agents ; 63(5): 107152, 2024 May.
Article em En | MEDLINE | ID: mdl-38513747
ABSTRACT

INTRODUCTION:

Ceftazidime-avibactam (CAZ-AVI) is a new option to treat KPC- and OXA-48 carbapenem-resistant Klebsiella pneumoniae (CRKP) infections. However, clinical evidence is limited regarding its use in treating CRKP infections, especially in solid organ transplantation (SOT) recipients. In this study, we assessed the efficacy of CAZ-AVI in treating CRKP infections in both the general population and the SOT recipients in comparison with other antibiotic regimens.

METHODS:

This is a single-centre retrospective cohort study of patients admitted between January 1, 2018 and June 30, 2021 with the diagnosis of CRKP infections receiving either CAZ-AVI or other regimens ≥ 72 hours and clinical outcomes were analysed.

RESULTS:

Of 200 patients with CRKP infections, 67 received CAZ-AVI, 133 received other regimens, and 50 were SOT recipients. In the SOT cohort, 30 patients received CAZ-AVI, and 20 received other regimens. The overall 30-day mortality was 38% in the SOT cohort. Compared with patients receiving other regimens, CAZ-AVI therapy resulted in lower 30-day mortality (23.3% vs. 60%, P = 0.014) and 90-day mortality (35.7% vs. 86.7%, P = 0.003), higher clinical cure (93.3% vs. 40%, P < 0.001) and microbiological clearance. Similar promising results of CAZ-AVI were also shown in the whole population cohort. Moreover, clinical outcomes of SOT recipients receiving CAZ-AVI were not inferior to those without SOT.

CONCLUSIONS:

CAZ-AVI therapy was associated with better clinical outcomes in CRKP infections in both the general population and SOT recipients. Considering the limitations of the present study, well-conducted RCTs are still warranted to confirm these findings.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por Klebsiella / Ceftazidima / Transplante de Órgãos / Combinação de Medicamentos / Compostos Azabicíclicos / Klebsiella pneumoniae / Antibacterianos Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por Klebsiella / Ceftazidima / Transplante de Órgãos / Combinação de Medicamentos / Compostos Azabicíclicos / Klebsiella pneumoniae / Antibacterianos Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article