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Effectiveness of Ceftazidime-Avibactam in Gram-Negative Nosocomial Pneumonia: A Real-World Study in India

Neha Gupta1, Sanjith Saseedharan2, Yashesh Paliwal3

  • 1Internal Medicine and Infectious Diseases, Fortis Memorial Research Institute, Gurugram, IND.

Cureus
|March 21, 2024
PubMed
Abstract

Insights

Ceftazidime-avibactam demonstrated effective clinical and microbiological cure rates for carbapenem-resistant Klebsiella pneumoniae nosocomial pneumonia and ventilator-associated pneumonia in Indian ICUs. This antibiotic offers a safer alternative with favorable outcomes in real-world settings.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Antimicrobial Stewardship

Background:

  • Nosocomial pneumonia in Indian ICUs has high incidence (9-58%) and mortality (30-70%).
  • Carbapenem-resistant Enterobacterales (CRE), particularly Klebsiella pneumoniae (KP), pose a significant treatment challenge.
  • Ceftazidime-avibactam offers an alternative to nephrotoxic colistin against CRE with a better safety profile.

Purpose of the Study:

  • To evaluate the effectiveness and usage patterns of ceftazidime-avibactam.
  • To assess clinical and microbiological cure rates in gram-negative hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP).
  • To analyze real-world data from Indian intensive care units (ICUs).

Main Methods:

  • Retrospective analysis of electronic medical records from three Indian medical centers.
  • Inclusion of patients with nosocomial pneumonia and documented gram-negative KP infection.
  • Assessment of clinical cure, microbiological cure, and treatment duration of ceftazidime-avibactam.

Main Results:

  • A clinical cure rate of 78.45% (91/116) was observed.
  • Microbiological cure was achieved in 69.23% (9/13) of patients.
  • Early initiation (within 72 hours) showed higher clinical cure rates (84.85%) and microbiological recovery (62.50%).

Conclusions:

  • Ceftazidime-avibactam is effective and well-tolerated for carbapenem-resistant KP nosocomial pneumonia and VAP.
  • It demonstrates favorable clinical outcomes and can be a viable treatment option.
  • Real-world data supports its use in challenging gram-negative infections in Indian ICUs.
Keywords:
ceftazidime-avibactamclinical curehospital-acquired pneumoniamicrobiological recoverynosocomial pneumoniaventilator-associated pneumonia

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