头孢他啶-阿维巴坦的实际使用、有效性和安全性：法国队列OZAVIE的结果

IF 2.9 4区医学 Q2 INFECTIOUS DISEASES

Infectious diseases now Pub Date : 2025-02-08 DOI:10.1016/j.idnow.2025.105036

Lionel Piroth , Virginie Vitrat , Vincent Le Moing , Philippe Bret , Yves Brault , William Greenwood , Marie-Charlotte Chopin , Eric Vicaut , Philippe Montravers , Pierre Tattevin , Alexandre Bleibtreu , on behalf of the OZAVIE research group

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引用次数: 0

摘要

背景：虽然难以治疗的多重耐药革兰氏阴性菌感染随着时间的推移而增加，但在41个法国中心评估了头孢他啶-阿维巴坦（CAZ-AVI）治疗住院患者的实际有效性、使用和安全性。sozavie是一项前瞻性、多中心、观察性研究，于2019年3月至2021年11月进行。在入组前14天内因感染而启动CAZ-AVI的住院成年患者符合条件。收集了人口统计学、临床、微生物学和治疗数据。如果患者死于初始感染，或感染持续存在并需要另一种抗生素或手术，或CAZ-AVI因不耐受而停用，则结果归类为“失败”，否则归类为“全面成功”。结果非“失败”、未死亡且在指数住院期间不需要其他抗生素的患者被归类为“治疗成功”。结果纳入257例患者：76名女性/181名男性，平均年龄58.4岁，患有糖尿病（30.0%），慢性肾功能衰竭（25.7%），终末期肝病（9.3%）和/或免疫功能低下（31.1%）。CAZ-AVI用于医院性肺炎（34.2%）、并发尿路感染（17.5%）、并发腹腔内感染（14.8%）和其他特定部位（27.6%）。主要病原菌为铜绿假单胞菌（52.4%）、克雷伯氏菌（34.9%）、肠杆菌（18.4%）。总体和治疗成功率分别为79.0%和63.4%，28天死亡率为20.2%。总体而言，17.4%的患者报告了可能与CAZ-AVI相关的不良事件，其中包括6.2%的严重ae。结论scaz - avi对各种感染（包括难以治疗的感染部位）和各种感染菌株（包括铜绿假单胞菌和肠杆菌）有效且耐受性良好。

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Real-world use, effectiveness, and safety of ceftazidime-avibactam: Results of the French cohort OZAVIE

Background

While difficult-to-treat multidrug-resistant Gram-negative bacteria infections increase over time, the real-world effectiveness, use, and safety of ceftazidime-avibactam (CAZ-AVI) for treating hospitalized patients was assessed in 41 French centers.

Procedures

OZAVIE was a prospective, multicenter, observational study conducted between March 2019 and November 2021. Hospitalized adult patients having initiated CAZ-AVI for infections within 14 days before enrolment were eligible. Demographic, clinical, microbiological, and therapeutic data were collected. Outcome was categorized as “failure” if the patient died from the initial infection, or if the infections persisted and required another antibiotic or surgery, or if CAZ-AVI was discontinued due to intolerance, and as “global success” otherwise. Patients whose outcome was not “failure”, did not die and required no other antibiotics during the index hospitalization were categorized as “therapeutic success”.

Results

257 patients were enrolled: 76 females/181 males, mean age 58.4 years, with diabetes (30.0 %), chronic renal failure (25.7 %), end-stage liver disease (9.3 %) and/or immunocompromised (31.1 %). CAZ-AVI was prescribed for nosocomial pneumonia (34.2 %), complicated urinary tract infections (17.5 %), complicated intra-abdominal infections (14.8 %) and other specified sites (27.6 %). The main pathogens were Pseudomonas aeruginosa (52.4 %), Klebsiella spp. (34.9 %), Enterobacter spp. (18.4 %). Global and therapeutic successes were observed in 79.0 % and 63.4 % of patients, respectively, and 28-day mortality was 20.2 %. Overall, adverse events possibly related to CAZ-AVI were reported in 17.4 % of patients, including serious AEs in 6.2 %.

Conclusions

CAZ-AVI is effective and well tolerated for treating various infections – including difficult-to-treat infection sites – and for treating various infections strains, including Pseudomonas aeruginosa and Enterobacter spp.

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