Real-world, Multicenter Experience With Meropenem-Vaborbactam for Gram-Negative Bacterial Infections Including Carbapenem-Resistant Enterobacterales and Pseudomonas aeruginosa
| Autor: | Veena Venugopalan, Abdalhamid M Lagnf, Lee Amaya, Kyle C Molina, Jinhee Jo, Michael P. Veve, David Allen, Stephen Saw, Kevin W. Garey, Taylor Morrisette, Michael J. Rybak, Susan L. Davis, Lilian M. Abbo, Kimberly C. Claeys, Travis J Carlson, Vasilios Athans, Jessica K. Ortwine, Sarah C J Jorgensen, Ana D Vega, Kailynn DeRonde, Wesley D Kufel, Marco R Scipione, Christine Yost, Ryan P. Mynatt, Jing J. Zhao, Mathew Miller, Sara Alosaimy |
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| Rok vydání: | 2021 |
| Předmět: |
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medicine.medical_specialty business.industry Pseudomonas aeruginosa multidrug-resistant meropenem-vaborbactam Retrospective cohort study Odds ratio Logistic regression medicine.disease_cause Rash Major Articles Nephrotoxicity AcademicSubjects/MED00290 Infectious Diseases Oncology Internal medicine gram-negative infections medicine medicine.symptom business Adverse effect carbapenem-resistant Enterobacterales |
| Zdroj: | Open Forum Infectious Diseases |
| ISSN: | 2328-8957 |
| DOI: | 10.1093/ofid/ofab371 |
| Popis: | Background We aimed to describe the clinical characteristics and outcomes of patients treated with meropenem-vaborbactam (MEV) for a variety of gram-negative infections (GNIs), primarily including carbapenem-resistant Enterobacterales (CRE). Methods This is a real-world, multicenter, retrospective cohort within the United States between 2017 and 2020. Adult patients who received MEV for ≥72 hours were eligible for inclusion. The primary outcome was 30-day mortality. Classification and regression tree analysis (CART) was used to identify the time breakpoint (BP) that delineated the risk of negative clinical outcomes (NCOs) and was examined by multivariable logistic regression analysis (MLR). Results Overall, 126 patients were evaluated from 13 medical centers in 10 states. The most common infection sources were respiratory tract (38.1%) and intra-abdominal (19.0%) origin, while the most common isolated pathogens were CRE (78.6%). Thirty-day mortality and recurrence occurred in 18.3% and 11.9%, respectively. Adverse events occurred in 4 patients: nephrotoxicity (n = 2), hepatoxicity (n = 1), and rash (n = 1). CART-BP between early and delayed treatment was 48 hours (P = .04). MEV initiation within 48 hours was independently associated with reduced NCO following analysis by MLR (adusted odds ratio, 0.277; 95% CI, 0.081–0.941). Conclusions Our results support current evidence establishing positive clinical and safety outcomes of MEV in GNIs, including CRE. We suggest that delaying appropriate therapy for CRE significantly increases the risk of NCOs. |
| Databáze: | OpenAIRE |
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