Investigation of Patients Receiving Ceftazidime-Avibactam (CZA) in an Intensive Care Unit: A Retrospective Study from...

This study aimed to examine the clinical characteristics and prognosis of patients receiving ceftazidime-avibactam (CZA) treatment in an intensive care unit (ICU).

This observational, cross-sectional study was conducted with patients hospitalized in the ICU between June 2021 and April 2023. Among 1,900 patients, a total of 65 were identified to have received CZA treatment. All patients receiving this treatment were included in the study. We recorded patients' demographic data and comorbid diseases. We also investigated clinical outcomes in the ICU, such as sepsis, the requirement for mechanical ventilation (MV), mortality rates, and clinical features regarding infections.

Of the 65 patients, 69.2% were male, with an average age of 65±15 years. The overall mortality rate was 70.8%. The most common type of infection and the most frequently isolated pathogen were pneumonia (61.5%) and Klebsiella pneumoniae (73.8%), respectively. Deceased patients had clinically poorer scores on the Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE-II), and Sequential Organ Failure Assessment (SOFA) than survivors (p=0.006, p<0.001 and p<0.001, respectively). The rate of colistin exposure before CZA treatment was higher among dying patients (p=0.036). Multiple regression analyses indicated that factors independently associated with ICU mortality were the need for mechanical ventilation support [Odds ratio (OR): 15.155; p=0.023), development of septic shock (OR: 8.558; p=0.017), and APACHE-II score (OR: 1.146; p=0.045).

Our findings suggest that the development of septic shock, the requirement for mechanical ventilation (MV), and high APACHE-II and Sequential Organ Failure Assessment (SOFA) scores, and low GCS scores may be indicators of poor prognosis for patients requiring CZA.