Clinical impact of ceftazidime/avibactam on the treatment of suspected or proven infections in a large cohort of patients with haematological malignancies: a multicentre observational real-world study.

Autor:	Tumbarello M; Department of Medical Biotechnologies, University of Siena, Siena, Italy.; Infectious and Tropical Diseases Unit, Azienda Ospedaliero Universitaria Senese, Siena, Italy., Giuliano G; Infectious and Tropical Diseases Unit, Azienda Ospedaliero Universitaria Senese, Siena, Italy., Criscuolo M; Dipartimento Scienze di Laboratorio ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Roma, Italy., Del Principe MI; Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Roma, Italy., Papayannidis C; Istituto di Ematologia 'Seràgnoli', IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Fracchiolla NS; SC Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy., Dargenio M; Divisione di Ematologia e Centro Trapianti, CSE Vito Fazzi, Lecce, Italy., Cefalo M; Hematology, Sant'Eugenio Hospital, ASL ROMA2, Roma, Italy., Nadali G; U.O.C. Ematologia, Azienda Ospedaliera Universitaria Integrata di Verona, Ospedale Borgo Roma, Verona, Italy., Candoni A; Section of Haematology, Department of Medical and Surgical Sciences, University of Modena and Reggio, Modena, Italy., Buquicchio C; Ematologia con Trapianto, Ospedale Dimiccoli Barletta, Barletta, Italy., Marchesi F; Haematology and Stem Cell Transplantation Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy., Picardi M; Department of Clinical Medicine and Surgery, AOU Federico II, Naples, Italy., Lessi F; Department of Medicine, Hematology and Clinical Immunology Unit, University of Padova, Padova, Italy., Piedimonte M; Hematology, 'Sant'Andrea' Hospital-Sapienza, University of Rome, Rome, Italy., Prezioso L; Hematology and Bone Marrow Unit, Hospital University of Parma, Parma, Italy., Piccini M; SOD Ematologia, Università Di Firenze, AOU Careggi, Firenze, Italy., Cattaneo C; ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy., Busca A; Stem Cell Transplant Unit, AOU Citta' della Salute e della Scienza, Torino, Italy., Brunetti S; Dipartimento Scienze di Laboratorio ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Roma, Italy., Buzzatti E; Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Roma, Italy., Dedola A; Istituto di Ematologia 'Seràgnoli', IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy., Sciumé M; SC Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy., Di Renzo N; Divisione di Ematologia e Centro Trapianti, CSE Vito Fazzi, Lecce, Italy., Cesini L; Hematology, Sant'Eugenio Hospital, ASL ROMA2, Roma, Italy., Vatteroni A; U.O.C. Ematologia, Azienda Ospedaliera Universitaria Integrata di Verona, Ospedale Borgo Roma, Verona, Italy., Raffaelli F; UOC Malattie Infettive, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy., Pagano L; Dipartimento Scienze di Laboratorio ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Roma, Italy.; Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Università Cattolica del Sacro Cuore, Roma, Italy.
Jazyk:	angličtina
Zdroj:	The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2024 Nov 15. Date of Electronic Publication: 2024 Nov 15.
DOI:	10.1093/jac/dkae416
Abstrakt:	Objectives: To evaluate clinical impact of ceftazidime/avibactam on treating infections due to MDR Gram-negative bacteria in patients with haematological malignancies (HMs). Methods: We conducted a retrospective, observational study at 17 Italian haematological wards that included patients with HMs receiving ceftazidime/avibactam for the treatment of suspected or proven infections. The primary endpoint was all-cause mortality 30 days after infection onset. Secondary endpoints included the development of in vitro ceftazidime/avibactam resistance, adverse reactions and infection relapse. Results: Of 198 patients enrolled, 66 had fever of unknown origin and 132 had microbiologically proven infections (MPIs). Enterobacterales were responsible for 98 MPIs, with KPC producers accounting for 75% of these, and carbapenem-resistant Pseudomonas aeruginosa caused 25% of MPIs. The overall 30-day mortality rate was 17.7%. Infection relapse occurred in four patients with MPI. Patients who died within 30 days of infection onset tended to have pre-existing cerebrovascular diseases, a Charlson Comorbidity Index > 4 and septic shock at infection onset and had received inadequate initial antibiotic therapy. Thirty-day mortality was independently associated with septic shock at infection onset and inappropriate initial antibiotic therapy. Conclusions: Our study provides further evidence about the effectiveness of ceftazidime/avibactam in treating infections in patients with HMs. (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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