Real-world usage, effectiveness, and microbiological features of ceftazidime-avibactam in clinical practice in China.

BACKGROUND: Infections due to multidrug- and extensively drug-resistant bacteria can be difficult to treat and are associated with high mortality and burden of disease. Ceftazidime-avibactam (CVA) is used in patients with multidrug-resistant Gram-negative bacterial infections.

OBJECTIVE: To describe the real-world usage, effectiveness, and antimicrobial features of CVA in clinical practice in China.

METHODS: This multicenter, prospective observational study collected medical record data from adult patients (≥18 years) who had been hospitalized and treated with ≥1 dose of CVA. Clinical and microbiological outcomes were evaluated at the end of treatment, with clinical cure defined as resolution of infection following treatment with CVA.

RESULTS: Data were obtained from 220 adult patients receiving ≥1 dose of CVA in China. Infections indicated for CVA included pneumonia (64.5%), complicated intra-abdominal infection (16.8%) and bloodstream infection (7.3%). Klebsiella pneumoniae (129/227 isolates, 56.8%) was the most commonly identified pathogen, followed by Pseudomonas aeruginosa (33 isolates, 14.5%). Of 87 K. pneumoniae isolates, 76 (87.4%) were meropenem resistant and the same proportion carried cabapenemase genes. Low levels of resistance to CVA were observed across all isolates. Three-quarters of patients received CVA as definitive therapy. Clinical cure at end of treatment was achieved in 66.4% of patients and microbiological success in 69.6% of patients.

CONCLUSION: Findings from this study provide important real-world data on treatment patterns, microbiological features, and clinical and microbiological outcomes for CVA in routine clinical practice in China.