BackgroundCeftolozane/tazobactam is a novel cephalosporin and β-lactamase inhibitor antibiotic that has shown to have potent activity against Pseudomonas aeruginosa including strains exhibiting multi-drug resistance (MDR). The purpose of this study was to evaluate ceftolozane/tazobactam efficacy in MDR P. aeruginosa pneumonia compared with historical standard of care.MethodsThis was a retrospective cohort study of patients hospitalized across AdventHealth Central Florida campuses with MDR P. aeruginosa pneumonia from January 1, 2017 through December 31, 2018. This study included patients ≥ 18 years of age with a diagnosis of pneumonia and a positive respiratory culture with MDR P. aeruginosa. The primary outcome of this study was the rate of clinical cure by day 14 of definitive therapy. Secondary outcomes included 30-day readmission rate, average hospital length of stay (LOS), cost of admission, average ICU LOS after initiation of definitive antibiotic, and total days of antibiotic exposure for pneumonia. Data were analyzed with statistical computer software utilizing independent samples t-test and chi square tests of independence as appropriate.ResultsA total of 115 patients were included in the final analysis, 62 patients treated with ceftolozane/tazobactam and 53 patients treated with historical standard of care. Rate of clinical cure was similar between patients treated with ceftolozane/tazobactam, 72.6% (n = 45), and those treated with historical standard of care, 67.9% (n = 36), {X2 (1) = 0.297, p = 0.683}. Other outcomes assessed were also similar between groups except for average hospital length of stay (42.7 days vs. 30.3 days t(113) = 2.054, p = 0.042), and cost of admission ($78,550 vs. $47,681, t(113) = 2.458, p = 0.016), which were significantly greater in the ceftolozane/tazobactam treatment group.ConclusionIn patients diagnosed with MDR P. aeruginosa pneumonia, clinical cure rates were not significantly different between those treated with ceftolozane/tazobactam compared with historical standard of care. Significantly greater hospital length of stay and cost of admission was associated with use of ceftolozane/tazobactam, although many patient factors may have influenced these results.Disclosures All authors: No reported disclosures.

Objectives Acute bacterial skin and soft tissue infections (ABSSSIs) are a leading cause of presentation to the emergency department (ED). This study aimed to determine the potential impact of utilizing oritavancin in the ED or observation unit (OBS) on hospital inpatient admission. Methods A single-center community teaching hospital developed a pharmacy-led pilot to evaluate the use of oritavancin as a measure to avoid hospital admissions/readmissions in appropriate patients with ABSSSIs. Prior to initiation of the oritavancin pilot, prespecified inclusion and exclusion criteria were determined for proper patient selection. The pilot ran from January 1 to December 31, 2017. The data were compared to corresponding data for an equal number of patients during the pilot period who had similar ABSSSI diagnoses to the oritavancin pilot group but received vancomycin. The primary outcome was length of stay (LOS), defined as the total time in hours from presentation to the ED until discharge home, including time spent in the OBS or inpatient unit. Results During the study period, 122 patients met the study criteria and 61 patients received oritavancin in the ED or OBS unit. These patients were compared to 61 consecutive patients during the pilot period who received vancomycin. Administration of oritavancin in the ED or OBS was associated with a significantly shorter mean LOS relative to the standard of care group (19.5 vs. 85.98 h, p < 0.01). All-cause 30-day readmissions were the same for both groups (6 vs. 6, p = 1). Conclusions These results suggest that use of oritavancin in the ED or OBS setting for ABSSSIs may shorten LOS without negatively affecting readmissions. Digital features To view digital features for this article go to

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