Ceftolozane/tazobactam for the treatment of serious P. aeruginosa infections: a multicenter nationwide clinical experience

CEFTABUSE study group

Research output: Contribution to journalArticle

Abstract

To describe the largest clinical experience using ceftolozane-tazobactam (C/T) for treatment of different type of Pseudomonas aeruginosa infections. A retrospective study was performed at 22 hospitals in Italy from June 2016 to March 2018. All adult patients treated with at least 4 days of C/T were enrolled. A successful clinical outcome was defined as complete resolution of clinical signs and symptoms related to P. aeruginosa infection and lack of microbiological evidence of infection. C/T treatment was documented in 101 patients with diverse infections, including nosocomial pneumonia (31.7%), acute bacterial skin and skin structure infections (30.8%), complicated UTI (13.8%), complicated IAI (12.8%), bone infections (8.9%) and primary bacteraemia (7.9%). Almost half of P.aeruginosa strains were XDR (51%), with 78% of the isolates resistant to at least one carbapenem. C/T was used as first-line therapy in 39 patients (34.6%). When used as second or later line, the most common reasons for discontinuation of previous antibiotics were in vitro resistance of P.aeuruginosa strain and clinical failure of previous therapy. Concomitant antibiotics was reported in 35% of patients. C/T doses were 1.5 grams/8h in 70 patients (69.3%) and 3 grams/8h in 31 patients (30.7%); the median duration of C/T therapy was 14 days. The overall clinical success was 83.2%. Significant lower success rates were observed in patients with sepsis or those receiving continuous renal replacement therapy. Mild adverse events were reported in only three patients. C/T demonstrated a favourable safety and tolerability profile regardless of the type of infection. Clinicians should be aware of the risk of clinical failure with C/T therapy in septic patients receiving continuous renal replacement therapy.

Original languageEnglish
JournalInternational Journal of Antimicrobial Agents
DOIs
Publication statusE-pub ahead of print - Nov 8 2018

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Infection
Pseudomonas Infections
Renal Replacement Therapy
Therapeutics
Pseudomonas aeruginosa
Anti-Bacterial Agents
tazobactam drug combination ceftolozane
Skin
Carbapenems
Cross Infection
Bacteremia
Italy
Signs and Symptoms
Sepsis
Pneumonia
Retrospective Studies
Safety
Bone and Bones

Cite this

@article{a7fe84a9d48d477c90433d70e50bae4f,
title = "Ceftolozane/tazobactam for the treatment of serious P. aeruginosa infections: a multicenter nationwide clinical experience",
abstract = "To describe the largest clinical experience using ceftolozane-tazobactam (C/T) for treatment of different type of Pseudomonas aeruginosa infections. A retrospective study was performed at 22 hospitals in Italy from June 2016 to March 2018. All adult patients treated with at least 4 days of C/T were enrolled. A successful clinical outcome was defined as complete resolution of clinical signs and symptoms related to P. aeruginosa infection and lack of microbiological evidence of infection. C/T treatment was documented in 101 patients with diverse infections, including nosocomial pneumonia (31.7{\%}), acute bacterial skin and skin structure infections (30.8{\%}), complicated UTI (13.8{\%}), complicated IAI (12.8{\%}), bone infections (8.9{\%}) and primary bacteraemia (7.9{\%}). Almost half of P.aeruginosa strains were XDR (51{\%}), with 78{\%} of the isolates resistant to at least one carbapenem. C/T was used as first-line therapy in 39 patients (34.6{\%}). When used as second or later line, the most common reasons for discontinuation of previous antibiotics were in vitro resistance of P.aeuruginosa strain and clinical failure of previous therapy. Concomitant antibiotics was reported in 35{\%} of patients. C/T doses were 1.5 grams/8h in 70 patients (69.3{\%}) and 3 grams/8h in 31 patients (30.7{\%}); the median duration of C/T therapy was 14 days. The overall clinical success was 83.2{\%}. Significant lower success rates were observed in patients with sepsis or those receiving continuous renal replacement therapy. Mild adverse events were reported in only three patients. C/T demonstrated a favourable safety and tolerability profile regardless of the type of infection. Clinicians should be aware of the risk of clinical failure with C/T therapy in septic patients receiving continuous renal replacement therapy.",
author = "{CEFTABUSE study group} and Matteo Bassetti and Nadia Castaldo and Annamaria Cattelan and Cristina Mussini and Elda Righi and Carlo Tascini and Francesco Menichetti and Mastroianni, {Claudio Maria} and Mario Tumbarello and Paolo Grossi and Stefania Artioli and Novella Carrannante and Ludovica Cipriani and Davide Coletto and Alessandro Russo and Margherita Digaetano and Raffaella Losito and Maddalena Peghin and Alessandro Capone and Stefano Nicol{\`e} and Antonio Vena",
note = "Copyright {\circledC} 2018. Published by Elsevier B.V.",
year = "2018",
month = "11",
day = "8",
doi = "10.1016/j.ijantimicag.2018.11.001",
language = "English",
journal = "International Journal of Antimicrobial Agents",
issn = "0924-8579",
publisher = "Elsevier",

}

TY - JOUR

T1 - Ceftolozane/tazobactam for the treatment of serious P. aeruginosa infections

T2 - a multicenter nationwide clinical experience

AU - CEFTABUSE study group

AU - Bassetti, Matteo

AU - Castaldo, Nadia

AU - Cattelan, Annamaria

AU - Mussini, Cristina

AU - Righi, Elda

AU - Tascini, Carlo

AU - Menichetti, Francesco

AU - Mastroianni, Claudio Maria

AU - Tumbarello, Mario

AU - Grossi, Paolo

AU - Artioli, Stefania

AU - Carrannante, Novella

AU - Cipriani, Ludovica

AU - Coletto, Davide

AU - Russo, Alessandro

AU - Digaetano, Margherita

AU - Losito, Raffaella

AU - Peghin, Maddalena

AU - Capone, Alessandro

AU - Nicolè, Stefano

AU - Vena, Antonio

N1 - Copyright © 2018. Published by Elsevier B.V.

PY - 2018/11/8

Y1 - 2018/11/8

N2 - To describe the largest clinical experience using ceftolozane-tazobactam (C/T) for treatment of different type of Pseudomonas aeruginosa infections. A retrospective study was performed at 22 hospitals in Italy from June 2016 to March 2018. All adult patients treated with at least 4 days of C/T were enrolled. A successful clinical outcome was defined as complete resolution of clinical signs and symptoms related to P. aeruginosa infection and lack of microbiological evidence of infection. C/T treatment was documented in 101 patients with diverse infections, including nosocomial pneumonia (31.7%), acute bacterial skin and skin structure infections (30.8%), complicated UTI (13.8%), complicated IAI (12.8%), bone infections (8.9%) and primary bacteraemia (7.9%). Almost half of P.aeruginosa strains were XDR (51%), with 78% of the isolates resistant to at least one carbapenem. C/T was used as first-line therapy in 39 patients (34.6%). When used as second or later line, the most common reasons for discontinuation of previous antibiotics were in vitro resistance of P.aeuruginosa strain and clinical failure of previous therapy. Concomitant antibiotics was reported in 35% of patients. C/T doses were 1.5 grams/8h in 70 patients (69.3%) and 3 grams/8h in 31 patients (30.7%); the median duration of C/T therapy was 14 days. The overall clinical success was 83.2%. Significant lower success rates were observed in patients with sepsis or those receiving continuous renal replacement therapy. Mild adverse events were reported in only three patients. C/T demonstrated a favourable safety and tolerability profile regardless of the type of infection. Clinicians should be aware of the risk of clinical failure with C/T therapy in septic patients receiving continuous renal replacement therapy.

AB - To describe the largest clinical experience using ceftolozane-tazobactam (C/T) for treatment of different type of Pseudomonas aeruginosa infections. A retrospective study was performed at 22 hospitals in Italy from June 2016 to March 2018. All adult patients treated with at least 4 days of C/T were enrolled. A successful clinical outcome was defined as complete resolution of clinical signs and symptoms related to P. aeruginosa infection and lack of microbiological evidence of infection. C/T treatment was documented in 101 patients with diverse infections, including nosocomial pneumonia (31.7%), acute bacterial skin and skin structure infections (30.8%), complicated UTI (13.8%), complicated IAI (12.8%), bone infections (8.9%) and primary bacteraemia (7.9%). Almost half of P.aeruginosa strains were XDR (51%), with 78% of the isolates resistant to at least one carbapenem. C/T was used as first-line therapy in 39 patients (34.6%). When used as second or later line, the most common reasons for discontinuation of previous antibiotics were in vitro resistance of P.aeuruginosa strain and clinical failure of previous therapy. Concomitant antibiotics was reported in 35% of patients. C/T doses were 1.5 grams/8h in 70 patients (69.3%) and 3 grams/8h in 31 patients (30.7%); the median duration of C/T therapy was 14 days. The overall clinical success was 83.2%. Significant lower success rates were observed in patients with sepsis or those receiving continuous renal replacement therapy. Mild adverse events were reported in only three patients. C/T demonstrated a favourable safety and tolerability profile regardless of the type of infection. Clinicians should be aware of the risk of clinical failure with C/T therapy in septic patients receiving continuous renal replacement therapy.

U2 - 10.1016/j.ijantimicag.2018.11.001

DO - 10.1016/j.ijantimicag.2018.11.001

M3 - Article

C2 - 30415002

JO - International Journal of Antimicrobial Agents

JF - International Journal of Antimicrobial Agents

SN - 0924-8579

ER -