2382. Ceftolozane/Tazobactam for the Treatment of Multidrug-Resistant Pseudomonas aeruginosa Infections in Immunocompromised Patients: A Multi-Center Study
| Autor: | Madeline King, Abdulrahman Elabor, Esther Molnar, Jason C. Gallagher |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
medicine.drug_class Polymyxin 030106 microbiology Cephalosporin medicine.disease_cause Tazobactam Microbiology Abstracts 03 medical and health sciences polycyclic compounds medicine Cephalosporin Antibiotic Pseudomonas aeruginosa business.industry organic chemicals biochemical phenomena metabolism and nutrition bacterial infections and mycoses medicine.disease Transplantation Pneumonia Infectious Diseases B. Poster Abstracts Oncology bacteria Ceftolozane business medicine.drug |
| Zdroj: | Open Forum Infectious Diseases |
| ISSN: | 2328-8957 |
| DOI: | 10.1093/ofid/ofy210.2035 |
| Popis: | Background Ceftolozane/tazobactam (TOL-TAZ) is a novel cephalosporin antibiotic combined with a known β-lactamase inhibitor. It has activity against some extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and multidrug-resistant Pseudomonas aeruginosa (MDRPA). To date, little experience has been published on outcomes with TOL-TAZ for MDRPA infections in immunocompromised patients. Methods This was a retrospective study of adult patients (≥18 years) with an immunocompromising condition (solid-organ transplant; hematologic malignancy; solid tumors; metastatic cancer) at 20 academic medical centers who had microbiologically confirmed MDRPA isolated in culture and received TOL-TAZ for at least 24 hours. 30-day survival, in-hospital mortality, and the rates of microbiologic and clinical cure were assessed. Results Characteristic Result (N = 65) Immunocompromising condition:Solid-organ transplantSolid tumorLeukemiaLymphoma/multiple myelomaMetastatic cancer n(%)35 (53.8)20 (30.7)4 (6.1)3 (4.6)3 (4.6) Male, n(%) 38 (58.4) Age (median, IQR) 64 (20–87) Charlson Comorbidity Index (median, IQR) 6 (1–12) APACHE II score (median, IQR) 20 (4–41) ICU, n(%) 37(56.9) Hospital day index infection diagnosed (median, IQR) 17 (0–265) Hospital day TOL-TAZ started (median, IQR) 19 (0–284) 3grs q8hrs, n(%)1.5grs q8hrs, n(%) 23 (35.3)23 (35.3) Concomitant IV antibiotics, n(%)Aminoglycoside, n/N(%)Fluoroquinolone, n/N(%)Polymyxin, n/N(%)Β-lactam, n/N(%) 15 (23.0)7/15 (46.7)4/15 (26.7)3/15 (20)1/15 (6.6) TOL-TAZ susceptible isolates, n/N (%) 35/37 (94.6) Outcomes by primary infection Primary infection n (%) 30-day survival n/N(%) Microbiologic cure n/N(%) Clinical cure n/N(%) Pneumonia 33 (50.7) 30/33 (90.9) 24/33 (72.7) 28/33 (84.8) Wound/Bone/Joint 12 (18.4) 8/12 (66.6) 7/12 (58.3) 7/12 (58.3) UTI 9 (13.8) 7/9 (77.7) 7/9 (77.7) 8/9 (88.8) Intra-abdominal 7 (10.7) 7/7 (100) 7/7 (100) 4/7 (57.1) Bloodstream 4 (6.1) 4/4 (100) 4/4 (100) 4/4 (100) Overall outcomes, n(%) 30-day survival 56 (86.1) In-hospital mortality 17 (26.1) Microbiologic cure 49 (75.3) Clinical cure 51(78.4) Conclusion In this study of 65 critically-ill immunocompromised patients, the 30-day survival was 86.1%; clinical cure was78.4% and microbiologic cure 75.3%. TOL-TAZ is a viable option for immunocompromised patients with MDRPA infections. Disclosures J. Gallagher, Achaogen: Consultant, Consulting fee. Merck: Consultant, Grant Investigator and Speaker’s Bureau, Consulting fee and Research grant. Allergan: Consultant and Speaker’s Bureau, Consulting fee. Astellas: Consultant and Speaker’s Bureau, Consulting fee. Cempra: Consultant, Consulting fee. Cidara: Consultant, Consulting fee. CutisPharma: Consultant, Consulting fee. Paratek: Consultant, Consulting fee. Shionogi: Consultant, Consulting fee. Tetraphase: Consultant, Consulting fee. Theravance: Consultant, Consulting fee. The Medicines Company: Consultant, Consulting fee. Melinta: Speaker’s Bureau, Consulting fee. |
| Databáze: | OpenAIRE |
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