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Multicenter evaluation of ceftazidime-avibactam use in carbapenem-resistant Klebsiella pneumoniae bloodstream infections in OXA-48 endemic regions. | LitMetric

AI Article Synopsis

  • Limited data exists on the use of ceftazidime-avibactam (CAZ-AVI) for treating carbapenem-resistant Klebsiella pneumoniae bloodstream infections (CRKP-BSIs), particularly in regions where OXA-48 is prevalent, like Turkey.
  • A study over several years analyzed 106 patients, showing that those who started treatment with CAZ-AVI had lower mortality rates compared to those who switched from other treatments, particularly when initiated on the same day as the blood culture.
  • The study concluded that CAZ-AVI is an effective treatment for CRKP-BSIs in OXA-48 endemic areas and emphasizes the importance of early treatment initiation to improve patient survival.

Article Abstract

Data in the literature on the use of ceftazidime-avibactam (CAZ-AVI) in carbapenem-resistant Klebsiella pneumoniae bloodstream infections (CRKP-BSIs) are limited especially in OXA-48 (Oxacillinase-48) predominant regions. Our study aimed to evaluate the effect of CAZ-AVI use on outcomes in CRKP-BSIs in Turkey, where OXA-48 is endemic. A multicenter retrospective observational study was conducted between January 2017 and September 2021. The effects of clinical and treatment characteristics on 30-day mortality and relapse in CRKP-BSIs were analyzed. Predictors of outcomes were detected using a Cox regression model. The study enrolled 106 adults with CAZ-AVI-sensitive CRKP-BSIs who received CAZ-AVI for at least 72 h. Patients who received CAZ-AVI as initial therapy had lower mortality rates when compared to those who switched from last resort regimens [14.3% (n = 3/21) vs. 37.7% (n = 32/85), p = 0.04]. In multivariate analysis, older age and severe neutropenia were detected to be associated with higher mortality, significantly. Initiation of CAZ-AVI on the day of blood culture was obtained, was found to be significantly associated with lower mortality (HR: 0.25, CI: 0.07-0.84, p = 0.025). CAZ-AVI monotherapy is an important treatment option for CRKP-BSIs in OXA-48 endemic areas. Early initiation of CAZ-AVI should be preferred rather than switching from a last-resort regimen as it profoundly improves the survival rates.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530633PMC
http://dx.doi.org/10.1038/s41598-024-77259-zDOI Listing

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