Assessment of clinical effectiveness and safety of ceftazidime-avibactam in ‐treating multi-drug-resistant infections – A retrospective analysis at a tertiary care hospital in Saudi Arabia

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-05-23 DOI:10.1016/j.jiph.2025.102841

Eman Merghani Ali , Hanan A. Bakri , Otilia J.F. Banji , Amani Khardali , Moaddey Alfarhan , Hilal A. Thaibah , Dalin A. Hassan , Mohamed Eltaib Elmobark , Anugeetha Thacheril Mohanan , Mousa Mohammed Hassan Tawhari , Zamzam O. Mashraqi , Ahmed Hassan Suhaqi , Majed Abdu Soliman Akam , Rafat Fahad Mohammed Hawbani

{"title":"Assessment of clinical effectiveness and safety of ceftazidime-avibactam in ‐treating multi-drug-resistant infections – A retrospective analysis at a tertiary care hospital in Saudi Arabia","authors":"Eman Merghani Ali , Hanan A. Bakri , Otilia J.F. Banji , Amani Khardali , Moaddey Alfarhan , Hilal A. Thaibah , Dalin A. Hassan , Mohamed Eltaib Elmobark , Anugeetha Thacheril Mohanan , Mousa Mohammed Hassan Tawhari , Zamzam O. Mashraqi , Ahmed Hassan Suhaqi , Majed Abdu Soliman Akam , Rafat Fahad Mohammed Hawbani","doi":"10.1016/j.jiph.2025.102841","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The present study investigated the, effectiveness, safety and appropriateness of prescribing Ceftazidime-Avibactam (CAZ-AVI) to facilitate optimal clinical use and improve patient outcomes.</div></div><div><h3>Methods</h3><div>The retrospective study included 77 patients who received CAZ-AVI between June 2022 and October 2023. Data was extracted from the hospital's electronic records, and a questionnaire was used to gather information on care setting, medication history, therapies, dosage, treatment duration, adverse effects, culture site, microbiological response and appropriateness of CAZ-AVI prescriptions. <em>Chi</em>-squared analysis was performed, with p ≤ 0.05 considered statistically significant.</div></div><div><h3>Results</h3><div>Males comprised 53.2 % of the study population. A substantial number of patients were in the ICU, with 84.4 % requiring mechanical ventilation. Carbapenem-resistant <em>Klebsiella pneumoniae</em> was the primary pathogen in 87 % of patients. A significant association was observed between the genotype and clinical improvement (χ² = 9.78, P = 0.024), with the Oxa-48 +NDM genotype (44.2 %) being the most prevalent. Clinical improvement was significantly associated with the duration of therapy (<em>P</em> = 0.001), with improvement seen in 46.8 % of patients after treatment for 8–14 days. Adding a second antibiotic to CAZ-AVI did not significantly improve clinical outcomes statistically (P = 0.054), with aztreonam being the frequently co-administered agent (36.4 %). However, its use did not result in superior efficacy or outcomes compared to other second-line antibiotics (P = 0.18). Microbiological assays showed no growth of organisms in 70.1 % of patients after seven days and no recurrence in 77.9 % of patients within 15–30 days of treatment. Adverse effects were absent in most patients, and Infectious Diseases specialists appropriately filled out 97.4 % of the prescription order forms.</div></div><div><h3>Conclusions</h3><div>CAZ-AVI use was associated with clinical improvement in carbapenem-resistant <em>Klebsiella pneumonia</em> infections. The low incidence of adverse effects and frequent prescriptions filled by ID specialists support the appropriateness of its use.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102841"},"PeriodicalIF":4.7000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Infection and Public Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S187603412500190X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The present study investigated the, effectiveness, safety and appropriateness of prescribing Ceftazidime-Avibactam (CAZ-AVI) to facilitate optimal clinical use and improve patient outcomes.

Methods

The retrospective study included 77 patients who received CAZ-AVI between June 2022 and October 2023. Data was extracted from the hospital's electronic records, and a questionnaire was used to gather information on care setting, medication history, therapies, dosage, treatment duration, adverse effects, culture site, microbiological response and appropriateness of CAZ-AVI prescriptions. Chi-squared analysis was performed, with p ≤ 0.05 considered statistically significant.

Results

Males comprised 53.2 % of the study population. A substantial number of patients were in the ICU, with 84.4 % requiring mechanical ventilation. Carbapenem-resistant Klebsiella pneumoniae was the primary pathogen in 87 % of patients. A significant association was observed between the genotype and clinical improvement (χ² = 9.78, P = 0.024), with the Oxa-48 +NDM genotype (44.2 %) being the most prevalent. Clinical improvement was significantly associated with the duration of therapy (P = 0.001), with improvement seen in 46.8 % of patients after treatment for 8–14 days. Adding a second antibiotic to CAZ-AVI did not significantly improve clinical outcomes statistically (P = 0.054), with aztreonam being the frequently co-administered agent (36.4 %). However, its use did not result in superior efficacy or outcomes compared to other second-line antibiotics (P = 0.18). Microbiological assays showed no growth of organisms in 70.1 % of patients after seven days and no recurrence in 77.9 % of patients within 15–30 days of treatment. Adverse effects were absent in most patients, and Infectious Diseases specialists appropriately filled out 97.4 % of the prescription order forms.

Conclusions

CAZ-AVI use was associated with clinical improvement in carbapenem-resistant Klebsiella pneumonia infections. The low incidence of adverse effects and frequent prescriptions filled by ID specialists support the appropriateness of its use.

查看原文本刊更多论文

头孢他啶-阿维巴坦治疗多重耐药感染的临床有效性和安全性评估——对沙特阿拉伯一家三级医院的回顾性分析

本研究旨在探讨头孢他啶-阿维巴坦（CAZ-AVI）处方的有效性、安全性和适宜性，以促进临床最佳使用和改善患者预后。方法回顾性研究纳入了2022年6月至2023年10月期间接受CAZ-AVI治疗的77例患者。从医院的电子记录中提取数据，并使用问卷收集CAZ-AVI处方的护理环境、用药史、治疗方法、剂量、治疗持续时间、不良反应、培养部位、微生物反应和适宜性等信息。采用卡方分析，p ≤ 0.05认为有统计学意义。结果男性占研究人群的53.2% %。大量患者在ICU， 84.4 %需要机械通气。耐碳青霉烯肺炎克雷伯菌为主要病原菌，占87% %。基因型与临床改善之间存在显著相关性（χ²= 9.78,P = 0.024），其中Oxa-48 +NDM基因型（44.2% %）最为普遍。临床改善与治疗时间显著相关（P = 0.001），治疗8-14天后，46.8% %的患者出现改善。在CAZ-AVI中添加第二种抗生素并没有显著改善临床结果（P = 0.054），氮曲南是经常联合使用的药物（36.4% %）。然而，与其他二线抗生素相比，它的使用并没有带来更好的疗效或结果（P = 0.18）。微生物测定显示，70.1 %的患者在治疗7天后没有微生物生长，77.9% %的患者在治疗15-30天内没有复发。大多数患者没有出现不良反应，传染病专家正确填写了97.4% %的处方单。结论scaz - avi与耐碳青霉烯肺炎克雷伯菌感染的临床改善相关。低发生率的不良反应和频繁的处方填写ID专家支持其使用的适当性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.