Background: Clinical experience with ceftazidime-avibactam (CAZ-AVI) for treatment of infections due to multidrug or extremely resistant (MDR/XDR) Pseudomonas aeruginosa (P. aeruginosa) is limited.
Methods: A retrospective cohort study was conducted on patients with MDR/XDR P. aeruginosa infections treated with CAZ-AVI. The primary outcome was clinical cure by day 14, evaluated by logistic regression adjusted for the propensity score to receive CAZ-AVI as combination therapy. Secondary outcomes were 30-day all-cause mortality, 90-day recurrence, emerging CAZ-AVI resistance, and safety of therapy.
Results: Sixty-one first episodes of MDR/XDR P. aeruginosa infection were included. The most common source was lower respiratory tract infection (34.4%), 14.8% episodes developed bloodstream infection and 50.8% had sepsis at presentation. Ceftazidime-avibactam therapy was initiated at a median of 7.0 (interquartile range [IQR]: 3.5-12.0) days from symptom onset; it was used as combined therapy in 29 (47.5%) episodes. Clinical cure rate by day 14 was 54.1% and predictors of response were days to source control (adjusted odds ratio [aOR]: 0.84; 95% confidence interval [CI]: 0.72-0.98; P = 0.024), days until the initiation of CAZ-AVI therapy (aOR: 0.65; 95% CI: 0.49-0.86; P = 0.003), age (aOR: 1.07; 95% CI: 0.99-1.15; P = 0.066) and CAZ-AVI combination therapy (aOR: 0.02; 95% CI: 0.01-0.38; P = 0.009). Rates of 30-day all-cause mortality and 90-day recurrence were 13.1% and 12.5%, respectively. Emergence of drug resistance to CAZ-AVI was not detected. Treatment-related adverse events occurred in three episodes (4.9%).
Conclusions: CAZ-AVI constitutes a valid alternative for the treatment of infections due to MDR/XDR P. aeruginosa.
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http://dx.doi.org/10.1016/j.ijantimicag.2021.106517 | DOI Listing |
Ther Adv Vaccines Immunother
December 2024
Centre for Human Drug Research, Leiden, The Netherlands.
Respiratory syncytial virus (RSV) causes high worldwide infant mortality, as well as a high disease burden in the elderly. Efforts in vaccine development over the past 60 years have recently delivered three approved vaccines and two monoclonal antibodies (mAbs). Looking back at the eventful history of RSV vaccine development, several factors can be identified that have hampered the developmental pathway, including the occurrence of enhanced RSV disease (ERD) in the first vaccine attempt and the difficulty in characterizing and stabilizing the pre-fusion F protein as a vaccine target.
View Article and Find Full Text PDFCureus
December 2024
Department of Pathology, College of Medicine, King Saud University, Riyadh, SAU.
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View Article and Find Full Text PDFGMS J Med Educ
November 2024
Orthopedic Surgery Department, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, France.
Objective: Management of osteoarticular infections (OAI) represents a major public health challenge. To deal with this, the French Ministry of Health created the (CRIOAC) in 2008. CRIOAC functions as a national network of reference centers for OAI, with the aim of coordinating, providing expertise, offering training, and conducting research at the regional level.
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September 2024
Al Jalila Children's Hospital, Dubai Health, Dubai, United Arab Emirates.
Methemoglobinemia (MetHb) is a life-threatening condition that reduces the oxygen-carrying ability of hemoglobin. Acquired methemoglobinemia usually results from exposure to specific oxidizing agents. Symptoms and complications depend on the MetHb level, which can sometimes be fatal.
View Article and Find Full Text PDFInfect Drug Resist
December 2024
Pulmonary Diseases Department, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, People's Republic of China.
Background: Tuberculosis (TB) among women and infants during the perinatal period is not rare, particularly in countries with a high TB burden. And the risk would increase significantly following in vitro fertilization-embryo transfer (IVFET). Worse still, TB in this stage is apt to develop into severe forms in women and neonates, such as disseminated TB or tuberculous meningitis (TBM).
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