Ceftazidime-Avibactam Treatment for Carbapenemase-Producing Enterobacterales in a South African Children's Hospital

Area of Science:

• Pediatric Infectious Diseases
• Antimicrobial Stewardship
• Global Health

Background:

• Intra-abdominal infections (IAI) pose significant challenges in resource-constrained settings.
• Limited data exist on the efficacy of novel antibiotics like ceftazidime-avibactam in pediatric populations within these regions.

Purpose of the Study:

• To describe the use and outcomes of ceftazidime-avibactam in young children with IAI in a resource-limited country.
• To identify potential antimicrobial stewardship interventions to improve treatment effectiveness.

Main Methods:

• Retrospective case series of 17 pediatric patients treated with ceftazidime-avibactam for IAI.
• Data collection included patient demographics, infection characteristics, treatment details, and outcomes.

Main Results:

• The study population included 17 young children with intra-abdominal infections.
• The all-cause mortality rate was 53% in this cohort.
• Key antimicrobial stewardship interventions identified include earlier antibiotic initiation, dose optimization, precise infusion time recording, and judicious use of additional antibiotics.

Conclusions:

• Ceftazidime-avibactam use in young children with IAI in resource-limited settings is associated with high mortality.
• Implementing simple antimicrobial stewardship strategies can potentially enhance treatment outcomes and reduce mortality.