1926. Evaluation of Safety and Effectiveness of Continuous Infusion Ceftolozane/Tazobactam as Outpatient Parenteral Antimicrobial Therapy
Session: Poster Abstract Session: Clinical Practice Issues: HIV, Sepsis, QI, Diagnosis
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • 1926_IDWPOSTER.pdf (641.5 kB)
  • Background: Ceftolozane/tazobactam (C/T) is indicated for complicated intra-abdominal infections and complicated urinary tract infections (cUTI). Its spectrum of activity extends to most gram-negative bacteria including multidrug-resistant (MDR) Pseudomonas aeruginosa and extended-spectrum β-lactamase-producing enterobacteriaceae. Current dosing requires 8-hour intervals in order to meet appropriate concentrations above the MIC, making outpatient delivery logistically difficult. C/T is stable up to 24 hours at room temperature, allowing for potential continuous infusion. This study evaluated patients who received this novel dosing regimen at an outpatient infusion center.

    Methods: This study was a non-randomized, retrospective chart review of adult patients who received C/T August 2016 - January 2018 for any indication, including off-label, in the outpatient setting as a continuous infusion. Primary outcome evaluated was symptom resolution at the end of therapy documented in outpatient records. Secondary outcomes were microbiologic resolution at the end of therapy, if available, and patient satisfaction via a modified patient satisfaction survey assessed from follow-up phone call to patient.

    Results: Seven patients received C/T in the outpatient setting and were included in the study. Infections treated varied and included pneumonia (3), cUTI (2), skin and soft tissue (1), and bacteremia (1). Most patients received 4.5gm (with 1 receiving 9gm) C/T over 24 hours mixed with normal saline via an ambulatory infusion pump refilled each day at an outpatient infusion center. All 7 patients were infected with P. aeruginosa (4 being MDR) with 1 patient co-infected with E. coli. Susceptibility testing was performed on 3 P. aeruginosa isolates (2 susceptible and 1 intermediate). Six of 7 patients reported symptom resolution at the end of therapy. Three patients were microbiologically evaluable at the end of therapy and all 3 demonstrated microbiologic resolution. Three of 7 patients completed the satisfaction survey with all 3 reporting overall satisfaction. No adverse events were documented from any patients.

    Conclusion: Ceftolozane/tazobactam administered as a continuous infusion in the outpatient setting is a safe, effective, and convenient way to treat complicated P. aeruginosa infections.

    Bruce M Jones, PharmD, BCPS1, Kathryn Huelfer, PharmD Candidate2, Melissa Wynn, MD1, Henry N Young, PhD3 and Christopher Bland, PharmD, BCPS, FIDSA2, (1)St. Joseph's/Candler Health System, Savannah, GA, (2)Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Savannah, GA, (3)Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Athens, GA

    Disclosures:

    B. M. Jones, Merck: Grant Investigator , Grant recipient .

    K. Huelfer, None

    M. Wynn, None

    H. N. Young, None

    C. Bland, Merck: Grant Investigator and Speaker's Bureau , Grant recipient and Speaker honorarium .

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.