2051. Clinical Experience with Ceftolozane/Tazobactam at a Large Academic Medical Center
Session: Poster Abstract Session: Antimicrobial Resistant Infections: Treatment
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • Sacha_Ceftolozane Tazobactam ID Week.pdf (332.1 kB)
  • Background: Ceftolozane/tazobactam (C/T) is a novel cephalosporin formulated with a beta-lactamase inhibitor. It is currently FDA approved for the treatment of complicated intra-abdominal and urinary tract infections. In clinical practice, the niche of C/T appears to be for targeting multi-drug resistant (MDR) pathogens such as P. aeruginosa (PsA). However, clinical data supporting C/T use in the setting of MDR and/or non FDA-labeled indications are limited. This evaluation aimed to characterize the use of C/T at a health system with a large academic medical center.

    Methods: Retrospective case series of patients admitted to Cleveland Clinic Health System who received C/T. The primary objectives were to describe the utilization of C/T and determine clinical and microbiological cure rates. Secondary objectives included determining the percent susceptibility of PsA to C/T.

    Results: Between April 2015 and February 2016 there were 60 patient encounters evaluated. Most patients were in the intensive care unit (ICU) (61.7%) and many received C/T as combination therapy (48.3%). The mean duration of C/T use was 8 days. The most common source of infection was pneumonia (34 [56.7%]), followed by intra-abdominal infection (11 [18.3%]); 21.7% of encounters had a concomitant bacteremia. The primary pathogen isolated was PsA in 52 (86.7%) encounters; 40.4% of which were MDR and 25% were extensively drug resistant (XDR). The overall susceptibility rate for C/T was 83% against PsA. The rates against non-MDR, MDR and XDR isolates were 94.1%, 94.7% and 45.5%, respectively. Clinical and microbiological cure rates were 64.1% and 38.5%, respectively. Twenty-four patients died during hospitalization.

    Conclusion: In this primarily ICU patient population, the clinical cure rate was 64%. In patients with limited alternative antimicrobial options, this rate compares favorably to outcomes of therapy with greater toxicity. C/T susceptibility rates were higher among non-MDR and MDR PsA isolates compared to XDR. The overall susceptibility of PsA to C/T (83%) observed in this evaluation highlights the importance of susceptibility confirmation to guide therapy. Prospective clinical data are needed to evaluate the use of C/T in this severely ill patient population.

    Gretchen Sacha, PharmD1, Elizabeth Neuner, PharmD1, Vasilios Athans, PharmD1, Andrea Pallotta, PharmD1, Stephanie Bass, PharmD1, Seth Bauer, PharmD1 and Kyle Brizendine, MD2, (1)Pharmacy, Cleveland Clinic, Cleveland, OH, (2)Infectious Disease, Cleveland Clinic, Cleveland, OH

    Disclosures:

    G. Sacha, None

    E. Neuner, None

    V. Athans, None

    A. Pallotta, None

    S. Bass, None

    S. Bauer, None

    K. Brizendine, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.