789. Ceftolozane-tazobactam for the Treatment of Multi Drug Resistant Pseudomonas aeruginosa (MDRPA) Infections
Session: Poster Abstract Session: Treatment of Resistant Infections - Clinical Analyses
Thursday, October 5, 2017
Room: Poster Hall CD
Posters
  • IDWeek poster_EstherMolnar789.pdf (387.6 kB)
  • Background:

    Ceftolozane-tazobactam (TOL-TAZ) is a novel cephalosporin/beta-lactamase inhibitor combination with potent activity against Pseudomonas aeruginosa, including MDRPA. TOL-TAZ use for MDRPA infections has not been well-studied.

    Methods:

    We conducted a retrospective study to describe outcomes of patients treated with TOL-TAZ for MDR Pseudomonas aeruginosa infections at 3 academic medical centers. Patients were age ≥ 18 years who had MDRPA isolated in culture and received TOL-TAZ for at least 24 hours. The primary outcomes were 30-day and in-hospital mortality. Secondary outcomes were microbiological cure and clinical success. Microbiological cure was defined as negative culture at end of therapy; cure was presumed when clinical success occurred without follow-up cultures. Clinical success was defined as resolution of all signs and symptoms of infection. TOL-TAZ susceptibility results were collected when available.

    Results:

    Characteristics

    Results (N=34)

    Male gender, n(%)

    21 (61.8)

    Age (median, IQR)

    57 (42-66)

    Charlson Comorbidity Index (median, IQR)

    4 (2.25-5)

    APACHE II score (median, IQR)

    20 (13-26.8)

    ICU, n(%)

    23 (67.7)

    Solid organ transplant recipient, n(%)

    15 (44.1)

    Primary infection, n(%)

    Pneumonia

    Bacteremia

    Urinary tract

    Wound

    Intra-abdominal

    22 (64.7)

    6 (17.6)

    4 (11.8)

    4 (11.8)

    2 (5.8)

    Hospital day index infection diagnosed (median, IQR)

    8 (1-35)

    Hospital day TOL-TAZ started (median, IQR)

    18.5 (3-52)

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

    20 (58.8)

    Isolates susceptible to TOL-TAZ, n/N (%)

    16/17 (94)

    30-day mortality, n (%)

    7 (20.6)

    In-hospital mortality, n(%)

    8 (23.5)

    Microbiologic cure, n(%)

    21 (61.8)

    Clinical success, n(%)

    24 (70.6)

    Conclusion:

    In this severely ill population with MDRPA infections, 79.4% and 76.5% of patients were alive at 30-days and at the end of their stay, respectively. Some patients had positive cultures despite clinical resolution. TOL-TAZ is a potential option for patients with MDRPA infections.

    Esther Molnar, MD1, Emily Heil, PharmD, BCPS-AQID2, Kimberly Claeys, PharmD, BCPS2, Jon Hiles, PharmD3 and Jason Gallagher, PharmD, FCCP, FIDSA, BCPS4, (1)Infectious Disease, Temple University Hospital, Philadelphia, PA, (2)Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD, (3)Indiana University Health – Methodist and University Hospitals, Indianapolis, IN, (4)Pharmacy Practice, Temple University, Philadelphia, PA

    Disclosures:

    E. Molnar, Merck: Grant Investigator , Research grant

    E. Heil, None

    K. Claeys, None

    J. Hiles, None

    J. Gallagher, Merck: Consultant , Grant Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee , Educational grant and Speaker honorarium
    Allergan: Scientific Advisor and Speaker's Bureau , Consulting fee and Speaker honorarium
    Astellas: Scientific Advisor and Speaker's Bureau , Consulting fee and Speaker honorarium
    Achaogen: Scientific Advisor , Consulting fee
    Cidara: Consultant , Consulting fee
    Theravance: Scientific Advisor , Consulting fee
    Paratek: Scientific Advisor , Consulting fee
    The Medicines Company: Scientific Advisor , Consulting fee

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.