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Therapeutic insights: Use of ceftazidime-avibactam in pediatric patients
Özge Metin Akcan1, Mustafa Gençeli1, Talha Üstüntaş2
1Department of Pediatric Infectious Diseases, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
Insights
Ceftazidime-avibactam (CAZ-AVI) shows promise for treating severe multidrug-resistant bacterial infections in children. The study found high rates of microbiological eradication and clinical response with acceptable safety in this vulnerable population.
Area of Science:
- Infectious Diseases
- Pediatric Pharmacology
- Antimicrobial Resistance
Background:
- Rising global multidrug-resistant (MDR) bacteria necessitate novel treatments.
- Ceftazidime-avibactam (CAZ-AVI) is an approved drug combination for specific infections.
- Limited data exist on CAZ-AVI use in pediatric populations.
Purpose of the Study:
- To evaluate the efficacy and safety of CAZ-AVI in pediatric patients with life-threatening MDR infections.
- To document treatment outcomes and adverse events in this specific patient group.
Main Methods:
- Retrospective study at a tertiary children's hospital (Dec 2021 - Jul 2023).
- Included 21 pediatric patients with life-threatening MDR infections.
- Analyzed CAZ-AVI monotherapy and combination therapy outcomes.
Main Results:
- Microbiological eradication in 85.7% (18/21) and clinical response in 95.2% (20/21) of patients.
- Underlying conditions were common, including cerebral palsy and congenital diseases.
- Adverse events included anaphylaxis and elevated creatine phosphokinase; one death due to GI bleeding.
Conclusions:
- CAZ-AVI appears promising for treating severe MDR Gram-negative infections in children.
- Further research with larger cohorts is required to confirm efficacy and safety in pediatric patients.
Background:
The increasing worldwide prevalence of multidrug-resistant (MDR) bacteria underscores the pressing demand for innovative therapeutic solutions. Ceftazidime-avibactam (CAZ-AVI) represents a promising new drug combination that has received approval for specific infection types. However, there is limited information regarding its application in pediatric patients.
Methods:
This study investigates the effectiveness and adverse reactions associated with CAZ-AVI treatment in pediatric patients with life-threatening infections caused by MDR pathogens. The study was conducted at a tertiary children's hospital between December, 2021 and July, 2023.
Results:
A total of 21 patients with life-threatening infections caused by MDR pathogens were enrolled in the study. All patients had underlying medical conditions: 10 had cerebral palsy, four had congenital neurometabolic disease, two had Nieman-Pick disease, two had cystic fibrosis, two had primary immunodeficiency, and one had leukemia. Among these, 12 patients had tracheostomies. Eight patients received CAZ- AVI monotherapy, and 13 patients received combination therapy. Microbiological eradication was achieved in 18 patients (85.7%), and a clinical response was observed in 20 patients (95.2%). Two patients (9.5%) experienced relapse with the same bacteria. One patient developed anaphylaxis, and one patient had elevated creatine phosphokinase levels that normalized following discontinuation of treatment. One patient died during the study period due to gastrointestinal bleeding.
Conclusions:
Ceftazidime-avibactam may be a promising new drug option for the treatment of life-threatening infections caused by MDR Gram-negative microorganisms in pediatric patients. However, further studies with larger case series are needed to further evaluate the efficacy and safety of CAZ-AVI in this population.
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