Ceftolozane/Tazobactam for Resistant Drugs Pseudomonas aeruginosa Respiratory Infections: A Systematic Literature Review of the Real-World Evidence

Abstract

Background: Ceftolozane/tazobactam (C/T) is a β-lactam/β-lactamase inhibitor combination that mainly targets Gram-negative bacteria. The current international guidelines recommend including C/T treatment in the empirical therapy for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). Pseudomonas aeruginosa (PA) is one of the most challenging Gram-negative bacteria. We conducted a systematic review of all cases reported in the literature to summarize the existing evidence. Methods: The main electronic databases were screened to identify case reports of patients with drug-resistant PA respiratory infections treated with C/T. Results: A total of 22 publications were included for a total of 84 infective episodes. The clinical success rate was 72.6% across a wide range of comorbidities. The 45.8% of patients treated with C/T presented colonization by PA. C/T was well tolerated. Only six patients presented adverse events, but none had to stop treatment. The most common therapeutic regimens were 1.5 g every 8 h and 3 g every 8 h. Conclusion: C/T may be a valid therapeutic option to treat multidrug-resistant (MDR), extensively drug-resistant (XDR), pandrug-resistant (PDR), and carbapenem-resistant (CR) PA infections. However, further data are necessary to define the optimal treatment dosage and duration.

Ceftolozane/tazobactam for difficult‐to‐treat Gram‐negative infections: A real‐world tertiary hospital experience

“…38 Overall, C/T was well tolerated and only one patient developed nephrotoxicity. Rates of CDI in our study were similar to those in other studies, 14,39 but higher than registration studies (0.3%). Of note, almost all patients were previously treated with another antibiotic, and up to 50% received carbapenem treatment.…”

Extensively drug-resistant Pseudomonas aeruginosa: clinical features and treatment with ceftazidime/avibactam and ceftolozane/tazobactam in a tertiary care university hospital center in Portugal – A cross-sectional and retrospective observational study

“…Having been established that infections with resistant strains have a greater risk than susceptible strains (de Matos et al, 2018;Recio et al, 2018;Jean et al, 2020) it is not unexpected to find high mortality rates in this study. Nevertheless, 47.2% fatalities among patients with respiratory infections was higher than what had been previously described (Peña et al, 2013;Giaccari et al, 2021). The 26.5% mortality described among patients with urinary tract infections is similar to that described by Lamas Ferreiro et al (2017).…”

High burden of MDR, XDR, PDR, and MBL producing Gram negative bacteria causing infections in Kermanshah health centers during 2019-2020

“…The last line of drugs to treat infections caused by the most resistant bacteria such as Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacteriaceae are carbapenem antibiotics. The World Health Organization (WHO) made a global priority to direct research and discovery of new antibiotics to a list of 12 published antibiotic-resistant bacteria, particularly the carbapenem-resistant bacteria ( 1 , 2 ).…”