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Review
. 2021 May 24;11(6):474.
doi: 10.3390/life11060474.

Ceftolozane/Tazobactam for Resistant Drugs Pseudomonas aeruginosa Respiratory Infections: A Systematic Literature Review of the Real-World Evidence

Luca Gregorio Giaccari  1 , Maria Caterina Pace  1 , Maria Beatrice Passavanti  1 , Francesca Gargano  2 , Caterina Aurilio  1 , Pasquale Sansone  1
Affiliations
Review

Ceftolozane/Tazobactam for Resistant Drugs Pseudomonas aeruginosa Respiratory Infections: A Systematic Literature Review of the Real-World Evidence

Luca Gregorio Giaccari et al. Life (Basel). .

Abstract

Background: Ceftolozane/tazobactam (C/T) is a β-lactam/β-lactamase inhibitor combination that mainly targets Gram-negative bacteria. The current international guidelines recommend including C/T treatment in the empirical therapy for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). Pseudomonas aeruginosa (PA) is one of the most challenging Gram-negative bacteria. We conducted a systematic review of all cases reported in the literature to summarize the existing evidence.

Methods: The main electronic databases were screened to identify case reports of patients with drug-resistant PA respiratory infections treated with C/T.

Results: A total of 22 publications were included for a total of 84 infective episodes. The clinical success rate was 72.6% across a wide range of comorbidities. The 45.8% of patients treated with C/T presented colonization by PA. C/T was well tolerated. Only six patients presented adverse events, but none had to stop treatment. The most common therapeutic regimens were 1.5 g every 8 h and 3 g every 8 h.

Conclusion: C/T may be a valid therapeutic option to treat multidrug-resistant (MDR), extensively drug-resistant (XDR), pandrug-resistant (PDR), and carbapenem-resistant (CR) PA infections. However, further data are necessary to define the optimal treatment dosage and duration.

Keywords: Pseudomonas aeruginosa; carbapenem-resistant (CR); ceftolozane/tazobactam; extensively drug-resistant (XDR); hospital-acquired pneumonia (HAP); multidrug-resistant (MDR); pandrug-resistant (PDR); ventilator-associated pneumonia (VAP).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram study selection process.
Figure 2
Figure 2
Type of infection (a) and resistance profile (n, %)(b).
Figure 3
Figure 3
Co-infections (n, %).
Figure 4
Figure 4
Co-infection microorganisms.
Figure 5
Figure 5
Clinical outcome.
Figure 6
Figure 6
Microbiological outcome.
See this image and copyright information in PMC

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