Marc Xipell1, Sandra Paredes2, Leticia Fresco2, Marta Bodro2, Francesc Marco3, J A Martínez2, Alex Soriano2. 1. Infectious Diseases Department, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain. Electronic address: xipell@clinic.cat. 2. Infectious Diseases Department, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain. 3. Microbiology Department, Hospital Clínic-ISGlobal, University of Barcelona, Barcelona, Spain.
Abstract
OBJECTIVES: The incidence of infections caused by multidrug-resistant Pseudomonas aeruginosa (MDR-Pa) has become a concern of increasing relevance nowadays. Ceftolozane/tazobactam (C/T) is a novel fifth-generation cephalosporin/β-lactamase inhibitor combination with activity against MDR-Pa. METHODS: The clinical records of all patients diagnosed from May 2016 to May 2017 with an infection due to a MDR-Pa treated with C/T were retrospectively reviewed. RESULTS: A total of 23 patients with 24 episodes of infection due to MDR-Pa were included. The minimum inhibitory concentration (MIC) of C/T against MDR-Pa ranged from 0.75-8μg/mL. In 14 cases (58%) the use of C/T was off-label, including 8 respiratory tract infections (RTIs) and 6 skin and soft-tissue infections, whilst in 10 cases the use was for approved indications, including 7 urinary tract infections and 3 intra-abdominal infections. C/T was the first-line therapy in only three cases with a mean±standard deviation treatment duration of 9.3±4 days, and it was associated with another active drug (aminoglycoside or colistin) in 16 cases. The global clinical cure rate was 88% (21/24 episodes), and the 6-week mortality rate was 22% (5/23 patients) being higher in RTIs (37%). In these infections, three patients received 2/1g every 8h (q8h) and were cured without mortality, whilst three (60%) of five patients receiving 1/0.5g q8h died. CONCLUSION: C/T had good clinical responses in different types of infection, including both FDA-accepted and off-label indications. The results support the use of higher doses in RTIs.
OBJECTIVES: The incidence of infections caused by multidrug-resistant Pseudomonas aeruginosa (MDR-Pa) has become a concern of increasing relevance nowadays. Ceftolozane/tazobactam (C/T) is a novel fifth-generation cephalosporin/β-lactamase inhibitor combination with activity against MDR-Pa. METHODS: The clinical records of all patients diagnosed from May 2016 to May 2017 with an infection due to a MDR-Pa treated with C/T were retrospectively reviewed. RESULTS: A total of 23 patients with 24 episodes of infection due to MDR-Pa were included. The minimum inhibitory concentration (MIC) of C/T against MDR-Pa ranged from 0.75-8μg/mL. In 14 cases (58%) the use of C/T was off-label, including 8 respiratory tract infections (RTIs) and 6 skin and soft-tissue infections, whilst in 10 cases the use was for approved indications, including 7 urinary tract infections and 3 intra-abdominal infections. C/T was the first-line therapy in only three cases with a mean±standard deviation treatment duration of 9.3±4 days, and it was associated with another active drug (aminoglycoside or colistin) in 16 cases. The global clinical cure rate was 88% (21/24 episodes), and the 6-week mortality rate was 22% (5/23 patients) being higher in RTIs (37%). In these infections, three patients received 2/1g every 8h (q8h) and were cured without mortality, whilst three (60%) of five patients receiving 1/0.5g q8h died. CONCLUSION: C/T had good clinical responses in different types of infection, including both FDA-accepted and off-label indications. The results support the use of higher doses in RTIs.
Authors: Dafna Yahav; Christian G Giske; Alise Grāmatniece; Henrietta Abodakpi; Vincent H Tam; Leonard Leibovici Journal: Clin Microbiol Rev Date: 2020-11-11 Impact factor: 26.132
Authors: Olga Rodríguez-Núñez; Leonor Periañez-Parraga; Antonio Oliver; Jose M Munita; Anna Boté; Oriol Gasch; Xavier Nuvials; Aurélien Dinh; Robert Shaw; Jose M Lomas; Vicente Torres; Juanjo Castón; Rafael Araos; Lilian M Abbo; Robert Rakita; Federico Pérez; Samuel L Aitken; Cesar A Arias; M Luisa Martín-Pena; Asun Colomar; M Belén Núñez; Josep Mensa; José Antonio Martínez; Alex Soriano Journal: Open Forum Infect Dis Date: 2019-09-28 Impact factor: 3.835