A Multicenter Retrospective Study on Real-World Outcomes of ceftazidime-avibactam in gram-negative bacterial infection in Taiwan

Ceftazidime-avibactam (CAZ-AVI) has been launched in Asian countries for five years, local real-world data about infections, patient characteristics, efficacy, and safety of CAZ-AVI in gram-negative bacterial infection is limited. We conducted a multicenter, retrospective cohort study to investigate...

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Main Authors: Tsung Ying Zegma Yang, Yee Chun Chen, Yi Tsung Lin, Ching Tai Huang, Po Yu Liu, Po Liang Lu
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716524001838
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author Tsung Ying Zegma Yang
Yee Chun Chen
Yi Tsung Lin
Ching Tai Huang
Po Yu Liu
Po Liang Lu
author_facet Tsung Ying Zegma Yang
Yee Chun Chen
Yi Tsung Lin
Ching Tai Huang
Po Yu Liu
Po Liang Lu
author_sort Tsung Ying Zegma Yang
collection DOAJ
description Ceftazidime-avibactam (CAZ-AVI) has been launched in Asian countries for five years, local real-world data about infections, patient characteristics, efficacy, and safety of CAZ-AVI in gram-negative bacterial infection is limited. We conducted a multicenter, retrospective cohort study to investigate the clinical characteristics, microbiology, and outcomes of patients treated with CAZ-AVI for gram-negative bacterial infection in Taiwan. Among the 472 patients treated by CAZ-AVI, 44.9% had respiratory tract infections, 21.2% had complicated urinary tract infections, 12.5% had complicated intra-abdominal infections, and 9.5% had primary bacteremia. Most patients receiving ceftazidime/avibactam in Taiwan are older, have a high SOFA score (mean 8.4), and have a high Charlson Comorbidity Index score (75.1%). 90% (425/472) of CAZ-AVI were used as targeted therapy for pathogens including Klebsiella pneumoniae (304/472, 64.4%), Pseudomonas aeruginosa (84/472, 17.8%), Escherichia coli (39/472, 8.3%), and Enterobacter spp. (11/472, 2.3%). The overall clinical success rate is 58.1%, and the in-hospital mortality rate is 41.1%. The logistic regression model revealed a significantly higher clinical success rate for those who initiated CAZ-AVI within 24 - 48 hours than those receiving CAZ-AVI > 72 hours. The multivariate logistic regression analysis revealed that receiving immunomodulators, higher SOFA score, and Enterobacter spp. infection were the significant factors associated with in-hospital mortality.
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publishDate 2024-12-01
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spelling doaj-art-19c10e49df6f43b4b8ef2a9d72de2f562024-12-27T04:08:13ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-013923A Multicenter Retrospective Study on Real-World Outcomes of ceftazidime-avibactam in gram-negative bacterial infection in TaiwanTsung Ying Zegma Yang0Yee Chun Chen1Yi Tsung Lin2Ching Tai Huang3Po Yu Liu4Po Liang Lu5Department of Medical Laboratory and Regenerative Medicine, MacKay Medical College, New Taipei City, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung 807, TaiwanDivision of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Infection, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanCeftazidime-avibactam (CAZ-AVI) has been launched in Asian countries for five years, local real-world data about infections, patient characteristics, efficacy, and safety of CAZ-AVI in gram-negative bacterial infection is limited. We conducted a multicenter, retrospective cohort study to investigate the clinical characteristics, microbiology, and outcomes of patients treated with CAZ-AVI for gram-negative bacterial infection in Taiwan. Among the 472 patients treated by CAZ-AVI, 44.9% had respiratory tract infections, 21.2% had complicated urinary tract infections, 12.5% had complicated intra-abdominal infections, and 9.5% had primary bacteremia. Most patients receiving ceftazidime/avibactam in Taiwan are older, have a high SOFA score (mean 8.4), and have a high Charlson Comorbidity Index score (75.1%). 90% (425/472) of CAZ-AVI were used as targeted therapy for pathogens including Klebsiella pneumoniae (304/472, 64.4%), Pseudomonas aeruginosa (84/472, 17.8%), Escherichia coli (39/472, 8.3%), and Enterobacter spp. (11/472, 2.3%). The overall clinical success rate is 58.1%, and the in-hospital mortality rate is 41.1%. The logistic regression model revealed a significantly higher clinical success rate for those who initiated CAZ-AVI within 24 - 48 hours than those receiving CAZ-AVI > 72 hours. The multivariate logistic regression analysis revealed that receiving immunomodulators, higher SOFA score, and Enterobacter spp. infection were the significant factors associated with in-hospital mortality.http://www.sciencedirect.com/science/article/pii/S2213716524001838ceftazidime-avibactamreal-world experiencemultidrug-resistant gram-negative bacterial infections
spellingShingle Tsung Ying Zegma Yang
Yee Chun Chen
Yi Tsung Lin
Ching Tai Huang
Po Yu Liu
Po Liang Lu
A Multicenter Retrospective Study on Real-World Outcomes of ceftazidime-avibactam in gram-negative bacterial infection in Taiwan
Journal of Global Antimicrobial Resistance
ceftazidime-avibactam
real-world experience
multidrug-resistant gram-negative bacterial infections
title A Multicenter Retrospective Study on Real-World Outcomes of ceftazidime-avibactam in gram-negative bacterial infection in Taiwan
title_full A Multicenter Retrospective Study on Real-World Outcomes of ceftazidime-avibactam in gram-negative bacterial infection in Taiwan
title_fullStr A Multicenter Retrospective Study on Real-World Outcomes of ceftazidime-avibactam in gram-negative bacterial infection in Taiwan
title_full_unstemmed A Multicenter Retrospective Study on Real-World Outcomes of ceftazidime-avibactam in gram-negative bacterial infection in Taiwan
title_short A Multicenter Retrospective Study on Real-World Outcomes of ceftazidime-avibactam in gram-negative bacterial infection in Taiwan
title_sort multicenter retrospective study on real world outcomes of ceftazidime avibactam in gram negative bacterial infection in taiwan
topic ceftazidime-avibactam
real-world experience
multidrug-resistant gram-negative bacterial infections
url http://www.sciencedirect.com/science/article/pii/S2213716524001838
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