2034. Outcomes with ceftazidime/avibactam in patients with carbapenem-resistant Pseudomonas infections: a multi-center study
Session: Poster Abstract Session: Antimicrobial Resistant Infections: Treatment
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • CAZAVI for Pseudomons ID week 2016.pdf (375.4 kB)
  • Background: Ceftazidime-avibactam (CAZAVI) is a cephalosporin-beta-lactamase inhibitor combination that is active against Enterobacteriaceae and Pseudomonas aeruginosa that is resistant to other agents, including carbapenems and late-generation cephalosporins. This purpose of this study is to describe the outcomes of patients receiving ceftazidime-avibactam for Pseudomonas infections.

    Methods: A retrospective chart review was completed from March 2015 through April 2016 at 3 hospitals in the United States for adult patients who received ceftazidime/avibactam for a Pseudomonas infection. Patients were included if they received CAZAVI for at least 24 hours for a carbapenem-resistant Pseudomonas. Dosage was chosen by providers at individual sites. The primary outcome was in-hospital mortality. Microbiologic and clinical outcomes were also evaluated. Microbiological success required a negative culture at the end of therapy. Clinical success was judged by improved symptoms, improved imaging where relevant, and defervesence.

    Results:

    Characteristic

    Results (N=10)

    Male gender, n(%)

    7 (70)

    Age (median, IQR)

    72.5 (70-74.5)

    Charlson Comorbidity Index (median, IQR)

    6 (4-7.75)

    Pitt Bacteremia Score (median, IQR)

    2 (0.25-2)

    ICU, n(%)

    7 (10)

    Moderate-severe renal disease

    4 (40)

    Moderate-severe liver disease

    0 (0)

    Primary infection, n(%)

    Pneumonia

    Bacteremia

    Urinary tract

    Intra-abdominal

    Bone/joint

    Wound

    5 (50)

    1 (10)

    1 (10)

    1 (10)

    1 (10)

    1 (10)

    Hospital day CRE infection diagnosed (median, IQR)

    1.5 (1-23)

    Hospital day CAZAVI started (median, IQR)

    6.5 (2-25)

    Patients receiving concomitant therapy for index pathogen, n(%)

    5 (50)

    Isolates susceptible to CAZAVI, n/N (%)

    7/7 (100)

    In-hospital mortality, n(%)

    2 (20)

    Cure or presumed microbiologic cure, n(%)

    9 (90)

    Clinical success, n(%)

    8 (80)

    Conclusion: In this severely ill population, 90% of patients had presumed cure, 80% had clinical success, and 80% were alive at the end of their hospital stay. Ceftazidime/avibactam is a potential option for patients with multi-drug resistant organisms causing Pseudomonas infections, including those in intensive care.

    Madeline King, PharmD, Temple University School of Pharmacy, Philadelphia, PA, Vanthida Huang, PharmD, Midwestern University College of Pharmacy-Glendale, Glendale, AZ, Jason Gallagher, PharmD, FCCP, FIDSA, BCPS, Temple University, Philadelphia, PA and Emily Heil, PharmD, Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD

    Disclosures:

    M. King, None

    V. Huang, None

    J. Gallagher, Allergan: Scientific Advisor and Speaker's Bureau , Consulting fee and Speaker honorarium
    Merck: Scientific Advisor and Speaker's Bureau , Consulting fee and Speaker honorarium
    Astellas: Scientific Advisor and Speaker's Bureau , Consulting fee and Speaker honorarium

    E. Heil, 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.