BETTER OUTCOME OF HIGH-DOSE CEFTAZIDIME IN HEMATO – ONCOLOGICAL PATIENTS WITH INFECTIONS CAUSED BY EXTENSIVELY DRUG-RESISTANT PSEUDOMONAS AERUGINOSA
Background: P. aeruginosa sepsis in immunocompromised patients is serious complication of cancer treatment, especially in case of XDR pathogen. The purpose of the study is to evaluate the efficacy of high-dose ceftazidime in treatment of XDR P. aeruginosa infection and to compare it with the con...
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PAGEPress Publications
2022-12-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
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| Online Access: | http://www.mjhid.org/index.php/mjhid/article/view/5143 |
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| author | Alzbeta Zavrelova Jakub Radocha Pavla Paterova Pavel Zak Benjamin Visek Martin Sima |
| author_facet | Alzbeta Zavrelova Jakub Radocha Pavla Paterova Pavel Zak Benjamin Visek Martin Sima |
| author_sort | Alzbeta Zavrelova |
| collection | DOAJ |
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Background: P. aeruginosa sepsis in immunocompromised patients is serious complication of cancer treatment, especially in case of XDR pathogen.
The purpose of the study is to evaluate the efficacy of high-dose ceftazidime in treatment of XDR P. aeruginosa infection and to compare it with the conventionally treated cohort in hemato-oncological patients.
Methods: We identified 27 patients with XDR P. aeruginosa infection during the 2008-2018 period, 16 patients served as a conventionally treated cohort with antipseudomonal beta-lactam antibiotic in standard dose (cohort A), and 11 patients were treated with high-dose ceftazidime (cohort B). Most of the patients were neutropenic and under active treatment for their cancer in both cohorts.
Results: Mortality and related mortality were statistically significantly better for cohort B compared to cohort A, it was 18.2% and 9.1% for cohort B and 68.8% and 68.8% for cohort A, respectively. More patients in cohort A needed mechanical ventilation and renal replacement therapy, 75% and 50% for cohort A and 27.3% and 9.9% for cohort B, respectively. It corresponded well with the worst SOFA in cohort A in comparison to cohort B, 16 versus 7 respectively. Reversible neurotoxicity was seen only in two patients in cohort B.
Conclusion: Ceftazidime in high doses is a very potent ATB for the treatment of XDR P. aeruginosa infections in neutropenic cancer with acceptable toxicity.
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| format | Article |
| id | doaj-art-8d138b8039c44d728f49059b0e541a22 |
| institution | Kabale University |
| issn | 2035-3006 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj-art-8d138b8039c44d728f49059b0e541a222025-01-03T00:00:35ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062022-12-0115110.4084/MJHID.2023.001BETTER OUTCOME OF HIGH-DOSE CEFTAZIDIME IN HEMATO – ONCOLOGICAL PATIENTS WITH INFECTIONS CAUSED BY EXTENSIVELY DRUG-RESISTANT PSEUDOMONAS AERUGINOSAAlzbeta Zavrelova0Jakub Radocha1Pavla Paterova2Pavel Zak3Benjamin Visek4Martin Sima5a:1:{s:5:"en_US";s:131:"4th Department of Internal Medicine – Haematology, University Hospital and Charles University Faculty of Medicine, Hradec Kralove";}4th Department of Internal Medicine – Haematology, University Hospital and Charles University Faculty of Medicine, Hradec KraloveDepartment of Clinical Microbiology, University Hospital and Charles University Faculty of Medicine, Hradec Kralove 4th Department of Internal Medicine – Haematology, University Hospital and Charles University Faculty of Medicine, Hradec Kralove4th Department of Internal Medicine – Haematology, University Hospital and Charles University Faculty of Medicine, Hradec KraloveInstitute of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic Background: P. aeruginosa sepsis in immunocompromised patients is serious complication of cancer treatment, especially in case of XDR pathogen. The purpose of the study is to evaluate the efficacy of high-dose ceftazidime in treatment of XDR P. aeruginosa infection and to compare it with the conventionally treated cohort in hemato-oncological patients. Methods: We identified 27 patients with XDR P. aeruginosa infection during the 2008-2018 period, 16 patients served as a conventionally treated cohort with antipseudomonal beta-lactam antibiotic in standard dose (cohort A), and 11 patients were treated with high-dose ceftazidime (cohort B). Most of the patients were neutropenic and under active treatment for their cancer in both cohorts. Results: Mortality and related mortality were statistically significantly better for cohort B compared to cohort A, it was 18.2% and 9.1% for cohort B and 68.8% and 68.8% for cohort A, respectively. More patients in cohort A needed mechanical ventilation and renal replacement therapy, 75% and 50% for cohort A and 27.3% and 9.9% for cohort B, respectively. It corresponded well with the worst SOFA in cohort A in comparison to cohort B, 16 versus 7 respectively. Reversible neurotoxicity was seen only in two patients in cohort B. Conclusion: Ceftazidime in high doses is a very potent ATB for the treatment of XDR P. aeruginosa infections in neutropenic cancer with acceptable toxicity. http://www.mjhid.org/index.php/mjhid/article/view/5143ceftazidimeneutropenia;XDR P. aeruginosa infection |
| spellingShingle | Alzbeta Zavrelova Jakub Radocha Pavla Paterova Pavel Zak Benjamin Visek Martin Sima BETTER OUTCOME OF HIGH-DOSE CEFTAZIDIME IN HEMATO – ONCOLOGICAL PATIENTS WITH INFECTIONS CAUSED BY EXTENSIVELY DRUG-RESISTANT PSEUDOMONAS AERUGINOSA Mediterranean Journal of Hematology and Infectious Diseases ceftazidime neutropenia; XDR P. aeruginosa infection |
| title | BETTER OUTCOME OF HIGH-DOSE CEFTAZIDIME IN HEMATO – ONCOLOGICAL PATIENTS WITH INFECTIONS CAUSED BY EXTENSIVELY DRUG-RESISTANT PSEUDOMONAS AERUGINOSA |
| title_full | BETTER OUTCOME OF HIGH-DOSE CEFTAZIDIME IN HEMATO – ONCOLOGICAL PATIENTS WITH INFECTIONS CAUSED BY EXTENSIVELY DRUG-RESISTANT PSEUDOMONAS AERUGINOSA |
| title_fullStr | BETTER OUTCOME OF HIGH-DOSE CEFTAZIDIME IN HEMATO – ONCOLOGICAL PATIENTS WITH INFECTIONS CAUSED BY EXTENSIVELY DRUG-RESISTANT PSEUDOMONAS AERUGINOSA |
| title_full_unstemmed | BETTER OUTCOME OF HIGH-DOSE CEFTAZIDIME IN HEMATO – ONCOLOGICAL PATIENTS WITH INFECTIONS CAUSED BY EXTENSIVELY DRUG-RESISTANT PSEUDOMONAS AERUGINOSA |
| title_short | BETTER OUTCOME OF HIGH-DOSE CEFTAZIDIME IN HEMATO – ONCOLOGICAL PATIENTS WITH INFECTIONS CAUSED BY EXTENSIVELY DRUG-RESISTANT PSEUDOMONAS AERUGINOSA |
| title_sort | better outcome of high dose ceftazidime in hemato oncological patients with infections caused by extensively drug resistant pseudomonas aeruginosa |
| topic | ceftazidime neutropenia; XDR P. aeruginosa infection |
| url | http://www.mjhid.org/index.php/mjhid/article/view/5143 |
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