Real-life experience with ceftolozane/tazobactam in Canada: results from the CLEAR (Canadian LEadership on Antimicrobial Real-life usage) registry

• Published in: Journal of global antimicrobial resistance. Vol. 25; pp. 346 - 350
• Main Authors: Zhanel, George G., Dhami, Rita, Baxter, Melanie, Kosar, Justin, Cervera, Carlos, Irfan, Neal, Zvonar, Rosemary, Borgia, Sergio, Tessier, Jean-Francois, Dow, Gordon, Ariano, Robert, Dube, Maxime, Savoie, Michel, Bassetti, Matteo, Walkty, Andrew, Karlowsky, James A.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.06.2021; Elsevier
• Subjects: Adverse effect; Bacteraemia; Ceftolozane/tazobactam; CLEAR; Efficacy; Pneumonia; Ceftolozane/tazobactam; Efficacy; Bacteraemia; Pneumonia; Adverse effect; CLEAR; adverse effects; ceftolozane/tazobactam; pneumonia; efficacy; bacteremia
• ISSN: 2213-7165; 2213-7173
• DOI: 10.1016/j.jgar.2021.03.025

•Use of ceftolozane/tazobactam (C/T) in Canadian patients using data captured by the CLEAR registry.•C/T is used as directed therapy to treat a variety of severe infections caused multidrug-resistant Pseudomonas aeruginosa.•C/T is commonly used combined with other antimicrobials, with relatively high cure rates and an excellent safety profile. Ceftolozane/tazobactam is a cephalosporin/β-lactamase inhibitor combination with activity against Gram-negative bacilli. Here we report the use of ceftolozane/tazobactam in Canada using a national registry. The CLEAR registry uses a REDCapTM online survey to capture details associated with clinical use of ceftolozane/tazobactam. Data from 51 patients treated in 2020 with ceftolozane/tazobactam are available. Infections treated included hospital-acquired bacterial pneumonia (37.3% of patients), ventilator-associated bacterial pneumonia (15.7%), bone and joint infection (11.8%), complicated intra-abdominal infection (7.8%) and complicated skin and skin-structure infection (7.8%). Moreover, 17.6% of patients had bacteraemia and 47.1% were in intensive care. Ceftolozane/tazobactam was primarily used as directed therapy for Pseudomonas aeruginosa infections (92.2% of patients). Ceftolozane/tazobactam was used because of resistance to (86.3%), failure of (11.8%) or adverse effects from (2.0%) previously prescribed antimicrobials. Ceftolozane/tazobactam susceptibility testing was performed on isolates from 88.2% of patients. Ceftolozane/tazobactam was used in combination with another antimicrobial active against Gram-negative bacilli in 39.2% of patients [aminoglycosides (15.7%), fluoroquinolones (9.8%) and colistin/polymyxin B (7.8%)]. The dosage regimen was customised in all patients based on creatinine clearance. The treatment duration was primarily >10 days (60.8% of patients), with microbiological success in 60.5% and clinical success in 64.4% of patients. Moreover, 7.8% of patients had adverse effects not requiring drug discontinuation. In Canada, ceftolozane/tazobactam is used as directed therapy to treat a variety of severe infections caused by multidrug-resistant P. aeruginosa. It is commonly used in combination with other antimicrobials with relatively high microbiological/clinical cure rates and an excellent safety profile.