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Ceftazidime-Avibactam in Multidrug-Resistant Klebsiella spp. Infections: Is Monotherapy as Effective as Combination

Rukiyye Bulut1, İbrahim Erayman1, Bahar Kandemir1

  • 1Department of Infectious Diseases and Clinical Microbiology, Necmettin Erbakan University Faculty of Medicine, Konya 42080, Türkiye.

Antibiotics (Basel, Switzerland)
|February 27, 2026
PubMed

Insights

Ceftazidime-avibactam (CZA) shows good results for treating carbapenem-resistant Klebsiella (CRK) infections. Treatment duration, not combination vs. monotherapy, significantly impacts patient outcomes in real-world settings.

Area of Science:

  • Infectious Diseases
  • Clinical Pharmacy
  • Antimicrobial Resistance

Background:

  • Carbapenem-resistant Klebsiella (CRK) species are a major cause of difficult-to-treat healthcare-associated infections.
  • High mortality rates associated with CRK infections necessitate effective therapeutic options.

Purpose of the Study:

  • To evaluate the clinical outcomes of ceftazidime-avibactam (CZA) therapy in patients with CRK infections.
  • To compare the efficacy of CZA monotherapy versus combination therapy for CRK infections.

Main Methods:

  • Retrospective analysis of 99 patients with CRK-positive cultures treated with CZA for at least 72 hours.
  • Data collected included patient demographics, comorbidities, infection types, CZA treatment regimens, and clinical outcomes.
  • Statistical analysis focused on factors influencing clinical outcomes, including treatment duration and regimen type.

Main Results:

  • The majority of patients (89.9%) were in the intensive care unit, with bloodstream infections and ventilator-associated pneumonia being the most common infection types.
  • Overall treatment success was 76.8%, with clinical improvement noted by day 3.4 and microbiological eradication by day 4.7.
  • Treatment duration was the only significant factor influencing clinical outcomes (p < 0.001); no significant difference was observed between CZA monotherapy and combination therapy.

Conclusions:

  • Ceftazidime-avibactam (CZA) is an effective treatment for carbapenem-resistant Klebsiella (CRK) infections in a real-world clinical setting.
  • Treatment duration is a key determinant of successful outcomes in CRK infections treated with CZA.
  • Findings support CZA's role in managing severe CRK infections and inform antimicrobial stewardship strategies.

Keywords:
carbapenem-resistant Klebsiella spp.ceftazidime–avibactamclinical successmortality

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