Ceftolozane/Tazobactam for Treatment of Severe ESBL-Producing
Autor: | Bassetti, M., Vena, A., Giacobbe, D. R., Falcone, M., Tiseo, G., Giannella, M., Pascale, R., Meschiari, M., Digaetano, M., Oliva, A., Rovelli, C., Carannante, N., Losito, A. R., Carbonara, S., Mariani, M. F., Mastroianni, A., Angarano, G., Tumbarello, M., Tascini, C., Grossi, P., Mastroianni, C. M., Mussini, C., Viale, P., Menichetti, F., Viscoli, C., Russo, A., Verdenelli, S., Fabiani, S., Castaldo, N., Pecori, D., Carnellutti, A., Givone, F., Graziano, E., Merelli, M., Cadeo, B., Peghin, M., Cattelan, A., Cipriani, L., Coletto, D., Gianluca, R., Ciardi, M. R., Ajassa, C., Tieghi, T., Pontino, P., Raffaelli, F., Artioli, S., Caruana, G., Luzzati, R., Bontempo, G., Petrosillo, N., Capone, A., Rizzardini, G., Coen, M., Passerini, M., Guadagnino, G., Urso, F., Borgia, G., Gentile, I., Maraolo, A. E., Crapis, M., Venturini, S., Parruti, G., Trave, F., Girardis, M., Cascio, A., Gioe, C., Anselmo, M., Malfatto, E. |
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Přispěvatelé: | Bassetti, Matteo, Vena, Antonio, Giacobbe, Daniele Roberto, Falcone, Marco, Tiseo, Giusy, Giannella, Maddalena, Pascale, Renato, Meschiari, Marianna, Digaetano, Margherita, Oliva, Alessandra, Rovelli, Cristina, Carannante, Novella, Losito, Angela Raffaella, Carbonara, Sergio, Mariani, Michele Fabiano, Mastroianni, Antonio, Angarano, Gioacchino, Tumbarello, Mario, Tascini, Carlo, Grossi, Paolo, Mastroianni, Claudio Maria, Mussini, Cristina, Viale, Pierluigi, Menichetti, Francesco, Viscoli, Claudio, Russo, Alessandro, Bassetti M., Vena A., Giacobbe D.R., Falcone M., Tiseo G., Giannella M., Pascale R., Meschiari M., Digaetano M., Oliva A., Rovelli C., Carannante N., Losito A.R., Carbonara S., Mariani M.F., Mastroianni A., Angarano G., Tumbarello M., Tascini C., Grossi P., Mastroianni C.M., Mussini C., Viale P., Menichetti F., Viscoli C., Russo A., Verdenelli S., Fabiani S., Castaldo N., Pecori D., Carnellutti A., Givone F., Graziano E., Merelli M., Cadeo B., Peghin M., Cattelan A., Cipriani L., Coletto D., Gianluca R., Ciardi M.R., Ajassa C., Tieghi T., Pontino P., Raffaelli F., Artioli S., Caruana G., Luzzati R., Bontempo G., Petrosillo N., Capone A., Rizzardini G., Coen M., Passerini M., Guadagnino G., Urso F., Borgia G., Gentile I., Maraolo A.E., Crapis M., Venturini S., Parruti G., Trave F., Girardis M., Cascio A., Gioe C., Anselmo M., Malfatto E., Russo, Alessandro &, Luzzati, R. |
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
ceftolozane/tazobactam medicine.medical_treatment CRRT Tazobactam Enterobacterales Enterobacterale Internal medicine ESBL septic shock Major Article medicine Clinical endpoint Renal replacement therapy business.industry Septic shock Retrospective cohort study Odds ratio medicine.disease Ceftolozane/tazobactam AcademicSubjects/MED00290 Infectious Diseases Oncology Ceftolozane business Empiric therapy medicine.drug |
Zdroj: | Open Forum Infectious Diseases |
ISSN: | 2328-8957 |
Popis: | Background Few data are reported in the literature about the outcome of patients with severe extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) infections treated with ceftolozane/tazobactam (C/T), in empiric or definitive therapy. Methods A multicenter retrospective study was performed in Italy (June 2016–June 2019). Successful clinical outcome was defined as complete resolution of clinical signs/symptoms related to ESBL-E infection and lack of microbiological evidence of infection. The primary end point was to identify predictors of clinical failure of C/T therapy. Results C/T treatment was documented in 153 patients: pneumonia was the most common diagnosis (n = 46, 30%), followed by 34 cases of complicated urinary tract infections (22.2%). Septic shock was observed in 42 (27.5%) patients. C/T was used as empiric therapy in 46 (30%) patients and as monotherapy in 127 (83%) patients. Favorable clinical outcome was observed in 128 (83.7%) patients; 25 patients were considered to have failed C/T therapy. Overall, 30-day mortality was reported for 15 (9.8%) patients. At multivariate analysis, Charlson comorbidity index >4 (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.9–3.5; P = .02), septic shock (OR, 6.2; 95% CI, 3.8–7.9; P < .001), and continuous renal replacement therapy (OR, 3.1; 95% CI, 1.9–5.3; P = .001) were independently associated with clinical failure, whereas empiric therapy displaying in vitro activity (OR, 0.12; 95% CI, 0.01–0.34; P < .001) and adequate source control of infection (OR, 0.42; 95% CI, 0.14–0.55; P < .001) were associated with clinical success. Conclusions Data show that C/T could be a valid option in empiric and/or targeted therapy in patients with severe infections caused by ESBL-producing Enterobacterales. Clinicians should be aware of the risk of clinical failure with standard-dose C/T therapy in septic patients receiving CRRT. |
Databáze: | OpenAIRE |
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