Multicenter study of ceftolozane/tazobactam for treatment of Pseudomonas aeruginosa infections in critically ill patients
•This study reported the real-life clinical experience of ceftolozane-tazobactam in critically ill patients•Ceftolozane-tazobactam appeared to be effective for many serious Pseudomonas aeruginosa infections•The mortality was mainly related to the severity of the infection•No added benefit was observ...
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Published in | International journal of antimicrobial agents Vol. 57; no. 3; p. 106270 |
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Main Authors | , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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Elsevier Ltd
01.03.2021
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Abstract | •This study reported the real-life clinical experience of ceftolozane-tazobactam in critically ill patients•Ceftolozane-tazobactam appeared to be effective for many serious Pseudomonas aeruginosa infections•The mortality was mainly related to the severity of the infection•No added benefit was observed in high-dose ceftolozane-tazobactam or combination therapy with other antibiotics
This study aimed to assess the efficacy of ceftolozane-tazobactam (C/T) for treating infections due to Pseudomonas aeruginosa (P. aeruginosa) in critically ill patients.
A multicenter, retrospective and observational study was conducted in critically ill patients receiving different C/T dosages and antibiotic combinations for P. aeruginosa infections. Demographic data, localisation and severity of infection, clinical and microbiological outcome, and mortality were evaluated.
Ninety-five patients received C/T for P. aeruginosa serious infections. The main infections were nosocomial pneumonia (56.2%), intra-abdominal infection (10.5%), tracheobronchitis (8.4%), and urinary tract infection (6.3%). Most infections were complicated with sepsis (49.5%) or septic shock (45.3%), and bacteraemia (10.5%). Forty-six episodes were treated with high-dose C/T (3 g every 8 hours) and 38 episodes were treated with standard dosage (1.5 g every 8 hours). Almost half (44.2%) of the patients were treated with C/T monotherapy, and the remaining group received combination therapy with other antibiotics. Sixty-eight (71.6%) patients presented a favourable clinical response. Microbiological eradication was documented in 42.1% (40/95) of the episodes. The global ICU mortality was 36.5%. Univariate analysis showed that 30-day mortality was significantly associated (P < 0.05) with Charlson Index at ICU admission and the need of life-supporting therapies.
C/T appeared to be an effective therapy for severe infections due to P. aeruginosa in critically ill patients. Mortality was mainly related to the severity of the infection. No benefit was observed with high-dose C/T or combination therapy with other antibiotics. |
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AbstractList | BACKGROUNDThis study aimed to assess the efficacy of ceftolozane-tazobactam (C/T) for treating infections due to Pseudomonas aeruginosa (P. aeruginosa) in critically ill patients. PATIENTS AND METHODSA multicenter, retrospective and observational study was conducted in critically ill patients receiving different C/T dosages and antibiotic combinations for P. aeruginosa infections. Demographic data, localisation and severity of infection, clinical and microbiological outcome, and mortality were evaluated. RESULTSNinety-five patients received C/T for P. aeruginosa serious infections. The main infections were nosocomial pneumonia (56.2%), intra-abdominal infection (10.5%), tracheobronchitis (8.4%), and urinary tract infection (6.3%). Most infections were complicated with sepsis (49.5%) or septic shock (45.3%), and bacteraemia (10.5%). Forty-six episodes were treated with high-dose C/T (3 g every 8 hours) and 38 episodes were treated with standard dosage (1.5 g every 8 hours). Almost half (44.2%) of the patients were treated with C/T monotherapy, and the remaining group received combination therapy with other antibiotics. Sixty-eight (71.6%) patients presented a favourable clinical response. Microbiological eradication was documented in 42.1% (40/95) of the episodes. The global ICU mortality was 36.5%. Univariate analysis showed that 30-day mortality was significantly associated (P < 0.05) with Charlson Index at ICU admission and the need of life-supporting therapies. CONCLUSIONSC/T appeared to be an effective therapy for severe infections due to P. aeruginosa in critically ill patients. Mortality was mainly related to the severity of the infection. No benefit was observed with high-dose C/T or combination therapy with other antibiotics. •This study reported the real-life clinical experience of ceftolozane-tazobactam in critically ill patients•Ceftolozane-tazobactam appeared to be effective for many serious Pseudomonas aeruginosa infections•The mortality was mainly related to the severity of the infection•No added benefit was observed in high-dose ceftolozane-tazobactam or combination therapy with other antibiotics This study aimed to assess the efficacy of ceftolozane-tazobactam (C/T) for treating infections due to Pseudomonas aeruginosa (P. aeruginosa) in critically ill patients. A multicenter, retrospective and observational study was conducted in critically ill patients receiving different C/T dosages and antibiotic combinations for P. aeruginosa infections. Demographic data, localisation and severity of infection, clinical and microbiological outcome, and mortality were evaluated. Ninety-five patients received C/T for P. aeruginosa serious infections. The main infections were nosocomial pneumonia (56.2%), intra-abdominal infection (10.5%), tracheobronchitis (8.4%), and urinary tract infection (6.3%). Most infections were complicated with sepsis (49.5%) or septic shock (45.3%), and bacteraemia (10.5%). Forty-six episodes were treated with high-dose C/T (3 g every 8 hours) and 38 episodes were treated with standard dosage (1.5 g every 8 hours). Almost half (44.2%) of the patients were treated with C/T monotherapy, and the remaining group received combination therapy with other antibiotics. Sixty-eight (71.6%) patients presented a favourable clinical response. Microbiological eradication was documented in 42.1% (40/95) of the episodes. The global ICU mortality was 36.5%. Univariate analysis showed that 30-day mortality was significantly associated (P < 0.05) with Charlson Index at ICU admission and the need of life-supporting therapies. C/T appeared to be an effective therapy for severe infections due to P. aeruginosa in critically ill patients. Mortality was mainly related to the severity of the infection. No benefit was observed with high-dose C/T or combination therapy with other antibiotics. This study aimed to assess the efficacy of ceftolozane-tazobactam (C/T) for treating infections due to Pseudomonas aeruginosa (P. aeruginosa) in critically ill patients. A multicenter, retrospective and observational study was conducted in critically ill patients receiving different C/T dosages and antibiotic combinations for P. aeruginosa infections. Demographic data, localisation and severity of infection, clinical and microbiological outcome, and mortality were evaluated. Ninety-five patients received C/T for P. aeruginosa serious infections. The main infections were nosocomial pneumonia (56.2%), intra-abdominal infection (10.5%), tracheobronchitis (8.4%), and urinary tract infection (6.3%). Most infections were complicated with sepsis (49.5%) or septic shock (45.3%), and bacteraemia (10.5%). Forty-six episodes were treated with high-dose C/T (3 g every 8 hours) and 38 episodes were treated with standard dosage (1.5 g every 8 hours). Almost half (44.2%) of the patients were treated with C/T monotherapy, and the remaining group received combination therapy with other antibiotics. Sixty-eight (71.6%) patients presented a favourable clinical response. Microbiological eradication was documented in 42.1% (40/95) of the episodes. The global ICU mortality was 36.5%. Univariate analysis showed that 30-day mortality was significantly associated (P < 0.05) with Charlson Index at ICU admission and the need of life-supporting therapies. C/T appeared to be an effective therapy for severe infections due to P. aeruginosa in critically ill patients. Mortality was mainly related to the severity of the infection. No benefit was observed with high-dose C/T or combination therapy with other antibiotics. |
ArticleNumber | 106270 |
Author | Ballesteros, Daniel Soriano-Cuesta, Cruz Fernández-Simón, Inamculada Pérez-Pedrero, Maria José Pintado, Vicente López-Vergara, Loreto Chicot, Marta Rodríguez-Serrano, Diego Ruiz de Luna, Rafael Royuela, Ana Silva, Alberto Iranzo, Reyes Balandin, Bárbara Sancho-González, Milagros Asensio-Martín, Maria José Martínez-Sagasti, Fernando |
Author_xml | – sequence: 1 givenname: Bárbara surname: Balandin fullname: Balandin, Bárbara email: balandinmoreno@gmail.com organization: Department of Critical Care Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Spain – sequence: 2 givenname: Daniel surname: Ballesteros fullname: Ballesteros, Daniel organization: Department of Critical Care Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Spain – sequence: 3 givenname: Rafael surname: Ruiz de Luna fullname: Ruiz de Luna, Rafael organization: Department of Critical Care Medicine, Hospital Universitario Fundación de Alcorcón, Madrid, Spain – sequence: 4 givenname: Loreto surname: López-Vergara fullname: López-Vergara, Loreto organization: Department of Critical Care Medicine, Hospital Universitario Clínico San Carlos, Madrid, Spain – sequence: 5 givenname: Vicente surname: Pintado fullname: Pintado, Vicente organization: Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain – sequence: 6 givenname: Milagros surname: Sancho-González fullname: Sancho-González, Milagros organization: Department of Critical Care Medicine, Hospital Universitario Gregorio Marañón, Madrid, Spain – sequence: 7 givenname: Cruz surname: Soriano-Cuesta fullname: Soriano-Cuesta, Cruz organization: Department of Critical Care Medicine, Hospital Universitario Ramón y Cajal, Madrid, Spain – sequence: 8 givenname: Maria José surname: Pérez-Pedrero fullname: Pérez-Pedrero, Maria José organization: Department of Critical Care Medicine, Complejo Hospitalario de Toledo, Toledo, Spain – sequence: 9 givenname: Maria José surname: Asensio-Martín fullname: Asensio-Martín, Maria José organization: Department of Critical Care Medicine, Hospital Universitario La Paz, Madrid, Spain – sequence: 10 givenname: Inamculada surname: Fernández-Simón fullname: Fernández-Simón, Inamculada organization: Department of Critical Care Medicine, Complejo Hospitalario Ruber Juan Bravo, Madrid, Spain – sequence: 11 givenname: Diego surname: Rodríguez-Serrano fullname: Rodríguez-Serrano, Diego organization: Department of Critical Care Medicine, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain – sequence: 12 givenname: Alberto surname: Silva fullname: Silva, Alberto organization: Department of Critical Care Medicine, Hospital Universitario de Guadalajara, Guadalajara, Spain – sequence: 13 givenname: Marta orcidid: 0000-0003-2983-2356 surname: Chicot fullname: Chicot, Marta organization: Department of Critical Care Medicine, Hospital Universitario de La Princesa, Madrid, Spain – sequence: 14 givenname: Reyes surname: Iranzo fullname: Iranzo, Reyes organization: Department of Anesthesiology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain – sequence: 15 givenname: Fernando surname: Martínez-Sagasti fullname: Martínez-Sagasti, Fernando organization: Department of Critical Care Medicine, Hospital Universitario Clínico San Carlos, Madrid, Spain – sequence: 16 givenname: Ana surname: Royuela fullname: Royuela, Ana organization: Biostatistics Unit, Puerta de Hierro Biomedical Research Institute (IDIPHISA), CIBERESP, Madrid, Spain |
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Keywords | Ceftolozane/tazobactam Pseudomonas aeruginosa Intensive care unit |
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