Journal of infection and public health · 2025
Assessment of clinical effectiveness and safety of ceftazidime-avibactam in -treating multi-drug-resistant infections - A retrospective analysis at a tertiary care hospital in Saudi Arabia.
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Ali Eman Merghani, Bakri Hanan A, Banji Otilia J F, Khardali Amani, Alfarhan Moaddey, Thaibah Hilal A, Hassan Dalin A, Elmobark Mohamed Eltaib, Mohanan Anugeetha Thacheril, Tawhari Mousa Mohammed Hassan, Mashraqi Zamzam O, Suhaqi Ahmed Hassan, Akam Majed Abdu Soliman, Hawbani Rafat Fahad Mohammed
Аннотация
BACKGROUND: The present study investigated the, effectiveness, safety and appropriateness of prescribing Ceftazidime-Avibactam (CAZ-AVI) to facilitate optimal clinical use and improve patient outcomes.
METHODS: The retrospective study included 77 patients who received CAZ-AVI between June 2022 and October 2023. Data was extracted from the hospital's electronic records, and a questionnaire was used to gather information on care setting, medication history, therapies, dosage, treatment duration, adverse effects, culture site, microbiological response and appropriateness of CAZ-AVI prescriptions. Chi-squared analysis was performed, with p ≤ 0.05 considered statistically significant.
RESULTS: Males comprised 53.2 % of the study population. A substantial number of patients were in the ICU, with 84.4 % requiring mechanical ventilation. Carbapenem-resistant Klebsiella pneumoniae was the primary pathogen in 87 % of patients. A significant association was observed between the genotype and clinical improvement (χ² = 9.78, P = 0.024), with the Oxa-48 +NDM genotype (44.2 %) being the most prevalent. Clinical improvement was significantly associated with the duration of therapy (P = 0.001), with improvement seen in 46.8 % of patients after treatment for 8-14 days. Adding a second antibiotic to CAZ-AVI did not significantly improve clinical outcomes statistically (P = 0.054), with aztreonam being the frequently co-administered agent (36.4 %). However, its use did not result in superior efficacy or outcomes compared to other second-line antibiotics (P = 0.18). Microbiological assays showed no growth of organisms in 70.1 % of patients after seven days and no recurrence in 77.9 % of patients within 15-30 days of treatment. Adverse effects were absent in most patients, and Infectious Diseases specialists appropriately filled out 97.4 % of the prescription order forms.
CONCLUSIONS: CAZ-AVI use was associated with clinical improvement in carbapenem-resistant Klebsiella pneumonia infections. The low incidence of adverse effects and frequent prescriptions filled by ID specialists support the appropriateness of its use.
METHODS: The retrospective study included 77 patients who received CAZ-AVI between June 2022 and October 2023. Data was extracted from the hospital's electronic records, and a questionnaire was used to gather information on care setting, medication history, therapies, dosage, treatment duration, adverse effects, culture site, microbiological response and appropriateness of CAZ-AVI prescriptions. Chi-squared analysis was performed, with p ≤ 0.05 considered statistically significant.
RESULTS: Males comprised 53.2 % of the study population. A substantial number of patients were in the ICU, with 84.4 % requiring mechanical ventilation. Carbapenem-resistant Klebsiella pneumoniae was the primary pathogen in 87 % of patients. A significant association was observed between the genotype and clinical improvement (χ² = 9.78, P = 0.024), with the Oxa-48 +NDM genotype (44.2 %) being the most prevalent. Clinical improvement was significantly associated with the duration of therapy (P = 0.001), with improvement seen in 46.8 % of patients after treatment for 8-14 days. Adding a second antibiotic to CAZ-AVI did not significantly improve clinical outcomes statistically (P = 0.054), with aztreonam being the frequently co-administered agent (36.4 %). However, its use did not result in superior efficacy or outcomes compared to other second-line antibiotics (P = 0.18). Microbiological assays showed no growth of organisms in 70.1 % of patients after seven days and no recurrence in 77.9 % of patients within 15-30 days of treatment. Adverse effects were absent in most patients, and Infectious Diseases specialists appropriately filled out 97.4 % of the prescription order forms.
CONCLUSIONS: CAZ-AVI use was associated with clinical improvement in carbapenem-resistant Klebsiella pneumonia infections. The low incidence of adverse effects and frequent prescriptions filled by ID specialists support the appropriateness of its use.