Ceftazidime-Avibactam: A Retrospective Analysis of Multicenter Real-World Data and Factors Affecting Mortality

Area of Science:

• Infectious Diseases
• Antimicrobial Resistance
• Clinical Pharmacology

Background:

• Multidrug-resistant Gram-negative bacteria pose a significant threat, causing high-mortality infections.
• Overreliance on carbapenems has accelerated the development of carbapenem-resistant bacteria.
• Effective treatment alternatives are crucial for managing these challenging infections.

Purpose of the Study:

• To evaluate the clinical and microbiological effectiveness of ceftazidime-avibactam (CAZ-AVI).
• To assess the safety profile and side effects of CAZ-AVI treatment.
• To identify mortality predictors in patients with carbapenem-resistant Gram-negative infections treated with CAZ-AVI.

Main Methods:

• Retrospective analysis of 1245 patients with carbapenem-resistant Gram-negative infections.
• Patients received CAZ-AVI treatment and were monitored for clinical outcomes and microbiological eradication.
• Statistical analysis identified independent risk factors for mortality.

Main Results:

• Hospital-acquired pneumonia was the most common indication (47.8%), with Klebsiella pneumoniae being the predominant pathogen (81.3%).
• CAZ-AVI demonstrated high microbiological eradication rates (82.3%) with low clinical side effects (0.64%).
• Mortality rates at 7, 14, and 28 days were 13.8%, 28.9%, and 45.2%, respectively. Higher SOFA and APACHE II scores, mechanical ventilation, and elevated CRP were mortality predictors.

Conclusions:

• Ceftazidime-avibactam (CAZ-AVI) is a safe and effective treatment for severe infections caused by carbapenem-resistant Gram-negative bacteria.
• Real-world data supports CAZ-AVI as a vital option against resistant pathogens like Enterobacterales and Pseudomonas aeruginosa.
• Prognostic factors such as SOFA and APACHE II scores are critical for managing patient outcomes.