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Ceftazidime-Avibactam Use in a Case Series of Difficult-to-Treat or Recurrent Infections in Pediatric Patients with

Miguel García-Boyano1,2, María Alós Díez2,3, Lorena Fernández Tomé2,3

  • 1Pediatric Infectious Disease Department, La Paz University Hospital, 28046 Madrid, Spain.

Antibiotics (Basel, Switzerland)
|July 27, 2024
PubMed

Insights

Ceftazidime-avibactam (CZA) is effective and safe for treating multidrug-resistant Gram-negative infections in children, including those caused by OXA-48-producing Klebsiella pneumoniae. No resistance developed during treatment.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Resistance
  • Pharmacology

Background:

  • Multidrug-resistant Gram-negative infections, especially carbapenem-resistant strains, pose a global health threat.
  • Ceftazidime-avibactam (CZA) is a key treatment, but pediatric data are limited.
  • Understanding CZA's use in children with complex conditions is crucial.

Purpose of the Study:

  • To evaluate the efficacy and safety of CZA in pediatric patients with multidrug-resistant Gram-negative infections.
  • To describe clinical characteristics, treatment approaches, and outcomes in this population.
  • To assess CZA's impact on resistance development.

Main Methods:

  • Descriptive case series conducted at a Spanish tertiary hospital (February 2019 - January 2022).
  • Included pediatric patients (<16 years) treated with CZA for confirmed/suspected multidrug-resistant Gram-negative infections.
  • Examined clinical, microbiological, treatment, and outcome data.

Main Results:

  • Eighteen pediatric patients with complex chronic conditions received CZA.
  • Common conditions included liver transplantation (n=8) and biliary atresia (n=4).
  • Intra-abdominal infections due to OXA-48-producing Klebsiella pneumoniae were most frequent; CZA was well-tolerated. Two deaths occurred within one month, one infection-related. No resistance emerged despite repeat courses.

Conclusions:

  • Ceftazidime-avibactam demonstrates effectiveness and safety in pediatric patients with multidrug-resistant Gram-negative infections.
  • The lack of resistance development supports CZA's role as a primary option for OXA-48-producing infections.
  • Further research is warranted to confirm these findings in larger pediatric cohorts.
Keywords:
Klebsiella pneumoniaeOXA-48beta-lactamasecarbapenem-resistant Enterobacteriaceaeceftazidime–avibactamchildcholangitisintraabdominal infectionsliver transplantation

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