Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 26;13(8):699.
doi: 10.3390/antibiotics13080699.

Clinical Outcomes of Ceftazidime-Avibactam versus Ceftolozane-Tazobactam in Managing Pseudomonal Infections in Patients Undergoing Renal Replacement Therapy

Wasim S El Nekidy  1   2 , Mooza Al Ali  1 , Emna Abidi  1 , Rania El Lababidi  1 , Diaa Alrahmany  3 , Islam M Ghazi  4 , Mohamad Mooty  1 , Fadi Hijazi  1 , Muriel Ghosn  1 , Jihad Mallat  1   2
Affiliations

Clinical Outcomes of Ceftazidime-Avibactam versus Ceftolozane-Tazobactam in Managing Pseudomonal Infections in Patients Undergoing Renal Replacement Therapy

Wasim S El Nekidy et al. Antibiotics (Basel). .

Abstract

The optimal doses of ceftazidime-avibactam (CZA) and ceftolozane-tazobactam (C/T) for treating multidrug-resistant (MDR) Pseudomonas aeruginosa (PSA) in patients utilizing renal replacement therapy (RRT) are not well established. Hence, the objective of this study is to evaluate the clinical outcomes associated with the suggested doses of CZA and C/T in patients with PSA infection utilizing RRT.

Methods: This is a retrospective study conducted at our hospital between September 2018 and March 2022. Clinical cure was the primary endpoint, while microbiologic cure, 30-day recurrence, and 30-day mortality were the secondary endpoints.

Results: In total, 45 subjects met the inclusion criteria, with 25 receiving CZA and 20 receiving C/T. The median age was 69 (52-81) and 69 (61.5-83) years, respectively, while the median weight was 70 (55.5-81.5) and 66 (57-79) kg, respectively. Clinical cure was achieved in 12 (48%) subjects in the CZA group and 12 (60%) in the C/T group (p = 0.432). Of the 36 subjects who had repeated cultures, a microbiologic cure was achieved in 14/23 (60%) subjects and 10/13 (76.9%) subjects (p = 0.273). Thirty-day recurrence was reported in 3 (12%) cases in the CZA group and 6 (30%) in the C/T group (p = 0.082). The 30-day mortality was 13 (52%) subjects in the CZA group and 10 (50%) in the C/T group (p = 0.894). The median maintenance dose of CZA was 1.88 (0.94-3.75) g and 2.25 (1.5-2.25) g for C/T. Multivariate logistic regression analysis indicated that both drugs did not differ significantly in clinical cure. Bloodstream infection (BSI) (OR = 25, 95% CI: 1.63-411.7, p = 0.021) was the only independent factor associated with clinical cure in this population.

Conclusions: Our findings indicated that C/T and CZA did not significantly differ in achieving clinical cure in patients with MDR PSA infections undergoing RRT. Larger clinical trials are needed to confirm our findings.

Keywords: ceftazidime–avibactam; ceftolozane–tazobactam; dialysis; outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

References

    1. Vena A., Giacobbe D.R., Castaldo N., Cattelan A., Mussini C., Luzzati R., Rosa F.G., Del Puente F., Mastroianni C.M., Cascio A., et al. Clinical Experience with Ceftazidime-Avibactam for the Treatment of Infections due to Multidrug-Resistant Gram-Negative Bacteria Other than Carbapenem-Resistant Enterobacterales. Antibiotics. 2020;9:71. doi: 10.3390/antibiotics9020071. - DOI - PMC - PubMed
    1. Wenzler E., Bunnell K.L., Bleasdale S.C., Benken S., Danziger L.H., Rodvold K.A. Pharmacokinetics and Dialytic Clearance of Ceftazidime-Avibactam in a Critically Ill Patient on Continuous Venovenous Hemofiltration. Antimicrob. Agents Chemother. 2017;61:e00464-17. doi: 10.1128/AAC.00464-17. - DOI - PMC - PubMed
    1. Strich J.R., Ricotta E., Warner S., Lai Y.L., Demirkale C.Y., Hohmann S.F., Rhee C., Klompas M., Palmore T., Powers J.H., et al. Pharmacoepidemiology of Ceftazidime-Avibactam Use: A Retrospective Cohort Analysis of 210 US Hospitals. Clin. Infect. Dis. 2021;72:611–621. doi: 10.1093/cid/ciaa061. - DOI - PMC - PubMed
    1. Wooley M., Miller B., Krishna G., Hershberger E., Chandorkar G. Impact of renal function on the pharmacokinetics and safety of ceftolozane-tazobactam. Antimicrob. Agents Chemother. 2014;58:2249–2255. doi: 10.1128/AAC.02151-13. - DOI - PMC - PubMed
    1. Xiao A.J., Caro L., Popejoy M.W., Huntington J.A., Kullar R. PK/PD Target Attainment with Ceftolozane/Tazobactam Using Monte Carlo Simulation in Patients with Various Degrees of Renal Function, Including Augmented Renal Clearance and End-Stage Renal Disease. Infect Dis Ther. 2017;6:137–148. doi: 10.1007/s40121-016-0143-9. - DOI - PMC - PubMed

LinkOut - more resources