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. 2017 Jul 25;61(8):e00883-17.
doi: 10.1128/AAC.00883-17. Print 2017 Aug.

Ceftazidime-Avibactam Is Superior to Other Treatment Regimens against Carbapenem-Resistant Klebsiella pneumoniae Bacteremia

Ryan K Shields  1   2 , M Hong Nguyen  3   2 , Liang Chen  4 , Ellen G Press  1 , Brian A Potoski  1   2   5 , Rachel V Marini  2 , Yohei Doi  1   2 , Barry N Kreiswirth  4 , Cornelius J Clancy  1   6   7
Affiliations

Ceftazidime-Avibactam Is Superior to Other Treatment Regimens against Carbapenem-Resistant Klebsiella pneumoniae Bacteremia

Ryan K Shields et al. Antimicrob Agents Chemother. .

Abstract

There are no data comparing outcomes of patients treated with ceftazidime-avibactam versus comparators for carbapenem-resistant Enterobacteriaceae infections. At our center, ceftazidime-avibactam treatment of carbapenem-resistant Klebsiella pneumoniae bacteremia was associated with higher rates of clinical success (P = 0.006) and survival (P = 0.01) than other regimens. Across treatment groups, there were no differences in underlying diseases, severity of illness, source of bacteremia, or strain characteristics (97% produced K. pneumoniae carbapenemase). Aminoglycoside- and colistin-containing regimens were associated with increased rates of nephrotoxicity (P = 0.002).

Keywords: Klebsiella pneumoniae; Klebsiella pneumoniae carbapenemase; bacteremia; carbapenem-resistant Enterobacteriaceae; ceftazidime-avibactam; clinical success.

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Figures

FIG 1
FIG 1
Rates of 30-day clinical success across treatment regimens. Among patients with carbapenem-resistant Klebsiella pneumoniae bacteremia, rates of clinical success were significantly higher among patients receiving ceftazidime-avibactam than among those who received a carbapenem plus aminoglycoside (P = 0.04) or colistin (P = 0.009) or other regimens (P = 0.004). Other regimens included aminoglycoside (n = 11), carbapenem (n = 8), colistin (n = 4), tigecycline (n = 4), and ciprofloxacin (n = 2) monotherapy, as well as combination regimens of colistin plus tigecycline (n = 3), aminoglycoside plus tigecycline (n = 2), and 1 each of aminoglycoside plus cefepime, aminoglycoside plus colistin plus tigecycline, colistin plus aztreonam, colistin plus cefepime, colistin plus ciprofloxacin, carbapenem plus doxycycline, and carbapenem plus tigecycline.
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References

    1. Centers for Disease Control and Prevention. 2016. Healthcare-associated infections (HAIs): FAQs about choosing and implementing a CRE definition. https://www.cdc.gov/hai/organisms/cre/definition.html Accessed 6 April 6.
    1. Daikos GL, Tsaousi S, Tzouvelekis LS, Anyfantis I, Psichogiou M, Argyropoulou A, Stefanou I, Sypsa V, Miriagou V, Nepka M, Georgiadou S, Markogiannakis A, Goukos D, Skoutelis A. 2014. Carbapenemase-producing Klebsiella pneumoniae bloodstream infections: lowering mortality by antibiotic combination schemes and the role of carbapenems. Antimicrob Agents Chemother 58:2322–2328. doi:10.1128/AAC.02166-13. - DOI - PMC - PubMed
    1. Tzouvelekis LS, Markogiannakis A, Piperaki E, Souli M, Daikos GL. 2014. Treating infections caused by carbapenemase-producing Enterobacteriaceae. Clin Microbiol Infect 20:862–872. doi:10.1111/1469-0691.12697. - DOI - PubMed
    1. Clancy CJ, Chen L, Hong JH, Cheng S, Hao B, Shields RK, Farrell AN, Doi Y, Zhao Y, Perlin DS, Kreiswirth BN, Nguyen MH. 2013. Mutations of the ompK36 porin gene and promoter impact responses of sequence type 258, KPC-2-producing Klebsiella pneumoniae strains to doripenem and doripenem-colistin. Antimicrob Agents Chemother 57:5258–5265. doi:10.1128/AAC.01069-13. - DOI - PMC - PubMed
    1. Clancy CJ, Chen L, Shields RK, Zhao Y, Cheng S, Chavda KD, Hao B, Hong JH, Doi Y, Kwak EJ, Silveira FP, Abdel-Massih R, Bogdanovich T, Humar A, Perlin DS, Kreiswirth BN, Hong Nguyen M. 2013. Epidemiology and molecular characterization of bacteremia due to carbapenem-resistant Klebsiella pneumoniae in transplant recipients. Am J Transplant 13:2619–2633. doi:10.1111/ajt.12424. - DOI - PMC - PubMed

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