Experience With Ceftolozane-Tazobactam for the Treatment of Serious <i>Pseudomonas aeruginosa</i> Infections in Saudi Tertiary Care Center

Bosaeed, Mohammed; Ahmad, Ayoub; Alali, Alaa; Mahmoud, Ebrahim; Alswidan, L; Alsaedy, Abdulrahman; Aljuhani, Sameera; Alalwan, Bassam; Alshamrani, Majid M.; Alothman, Adel

doi:10.1177/1178633720905977

Cited by 19 publications

(39 citation statements)

References 15 publications

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“…Five countries were included: USA (12 studies [ 22 , 24 , 28 , 29 , 30 , 32 , 33 , 34 , 35 , 37 , 39 , 40 ]), Spain (4 studies [ 23 , 26 , 31 , 41 ]), Saudi Arabia (3 studies [ 21 , 25 , 42 ]), the UK (2 studies [ 36 , 38 ]), and France (1 study [ 27 ]).…”

Section: Resultsmentioning

confidence: 99%

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

Giaccari

Pace

Passavanti

et al. 2021

Life

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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.

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Section: Resultsmentioning

confidence: 99%

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

Giaccari

Pace

Passavanti

et al. 2021

Life

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“…In the USA, P. aeruginosa is among the top six bacterial species responsible for nosocomial infections, and the second most common pathogen causing ventilator-associated pneumonia and catheter-related urinary tract infections [2]. Despite advences in critical-care management, P. aeruginosa infections are associated with a mortality rate reaching 20% -50% [3,4,5,6,7].…”

Section: Introductionmentioning

confidence: 99%

Relationship between antibiotic resistance, biofilm formation, genes coding virulence factors and source of origin of <i>Pseudomonas aeruginosa</i> clinical strains

Ratajczak¹,

Kamińska²,

Nowak-Malczewska³

et al. 2021

Ann Agric Environ Med.

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Introduction and objective. Pseudomonas aeruginosa is an opportunistic pathogen that causes difficult with treating infections, especially in the immunocompromised and patients with some underlying disease. The aim of the study is to assess the antibiotic resistance, biofilm formation, and the presence of genes encoding various virulence factors in clinical isolates of P. aeruginosa. Materials and methods. Seventy-three clinical isolates of Pseudomonas aeruginosa were tested. Antimicrobial Susceptibility Testing (AST) and carbapenemases production was performed in accordance with the EUCAST guidelines. The ability to form biofilm was assessed by crystal violet assay. Genes encoding selected virulence factors were detected using standard polymerase chain reaction (PCR). Results. Among the 73 clinical isolates of P. aeruginosa, 41.1% were resistant to imipenem, 61.6% to meropenem, 30.1% to ciprofloxacin and 15.1% to tobramycin. Over 20% of isolates were producers of MBL. Antibiotic resistance profiling revealed that 23.3% of strains were sensitive to all antibiotics, 60.3% were LDR phenotype, and 16.4% were MDR phenotype. The majority of strains (73.6%) were strong-biofilm producers, 17.0% were moderate and 9.4% were weak biofilm producers. PCR analysis showed the presence of lasB, aprE and prpL genes in most of the tested strains (93.1%, 87.7% and 74.0%, respectively). Among strong biofilm producers, 22.2% were MDR, 63.0% of strains represented LDR phenotype, and 14.8 % were sensitive to all antibiotics. Moderate and weak biofilm producers were LDR and sensitive phenotypes only (respectively, 58.3% and 42.9 -LDR, 41.7 and 51.7% -sensitive). Conclusions. High frequency of MDR strains and their ability of biofilm formation and virulence factors may be a threat to effective therapy, and can increase morbidity and mortality of infected patients.

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“…Including studies that recruited patients from multiple countries, the most common study locations were the US (N = 50), [ 21 , 22 , 24 , 27 – 29 , 33 , 34 , 39 – 41 , 43 – 45 , 50 , 51 , 54 , 56 , 57 , 59 , 61 , 62 , 68 – 71 , 73 – 77 , 79 – 85 , 87 – 92 , 94 , 95 , 97 – 100 ] Spain (N = 15) [ 26 , 28 , 30 – 32 , 35 – 37 , 42 , 47 , 49 , 58 , 66 , 79 , 96 ], and Italy (N = 13) [ 18 , 20 , 23 , 25 , 48 , 52 , 53 , 55 , 64 , 67 , 72 , 79 , 86 ]. A variety of study designs were captured: 27 were non-comparative retrospective studies [ 18 , 19 , 22 , 24 , 25 , 28 , 32 , 33 , 40 , 41 ,…”

Section: Resultsmentioning

confidence: 99%

“…All 47 studies that included more than one patient reported clinical outcomes with C/T treatment: 39 reported clinical outcomes [ 18 – 21 , 23 – 43 , 81 , 83 – 86 , 90 , 92 , 94 – 100 ], 19 reported microbiological outcomes [ 19 , 21 , 24 , 31 – 33 , 35 – 38 , 40 , 41 , 43 , 80 , 94 , 96 – 98 , 100 ], and 45 reported mortality rates [ 18 – 43 , 79 , 80 , 82 – 92 , 94 – 98 , 100 ]. Clinical success rates ranged from 45.7 to 100.0%, with 27 studies (69%) reporting clinical success rates of > 70%.…”

Section: Resultsmentioning

confidence: 99%

Real-world use of ceftolozane/tazobactam: a systematic literature review

Puzniak

Dillon

Palmer

et al. 2021

Antimicrob Resist Infect Control

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Background Antibacterial-resistant gram-negative infections are a serious risk to global public health. Resistant Enterobacterales and Pseudomonas aeruginosa are highly prevalent, particularly in healthcare settings, and there are limited effective treatment options. Patients with infections caused by resistant pathogens have considerably worse outcomes, and incur significantly higher costs, relative to patients with susceptible infections. Ceftolozane/tazobactam (C/T) has established efficacy in clinical trials. This review aimed to collate data on C/T use in clinical practice. Methods This systematic literature review searched online biomedical databases for real-world studies of C/T for gram-negative infections up to June 2020. Relevant study, patient, and treatment characteristics, microbiology, and efficacy outcomes were captured. Results There were 83 studies comprising 3,701 patients were identified. The most common infections were respiratory infections (52.9% of reported infections), urinary tract infections (UTIs; 14.9%), and intra-abdominal infections (IAIs; 10.1%). Most patients included were seriously ill and had multiple comorbidities. The majority of patients had infections caused by P.aeruginosa (90.7%), of which 86.0% were antimicrobial-resistant. C/T was used as both a 1.5 g q8h and 3 g q8h dose, for a median duration of 7–56 days (varying between studies). Outcome rates were comparable between studies: clinical success rates ranged from 45.7 to 100.0%, with 27 studies (69%) reporting clinical success rates of > 70%; microbiological success rates ranged from 31 to 100%, with 14 studies (74%) reporting microbiological success rates of > 70%. Mortality rates ranged from 0 to 50%, with 31 studies (69%) reporting mortality rates of ≤ 20%. In comparative studies, C/T was as effective as aminoglycoside- or polymyxin-based regimens, and in some instances, significantly more effective. Conclusions The studies identified in this review demonstrate that C/T is effective in clinical practice, despite the diverse group of seriously ill patients, different levels of resistance of the pathogens treated, and varying dosing regimens used. Furthermore, comparative studies suggest that C/T offers a successful alternative to standard of care (SoC).

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Experience With Ceftolozane-Tazobactam for the Treatment of Serious Pseudomonas aeruginosa Infections in Saudi Tertiary Care Center

Cited by 19 publications

References 15 publications

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

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

Relationship between antibiotic resistance, biofilm formation, genes coding virulence factors and source of origin of <i>Pseudomonas aeruginosa</i> clinical strains

Real-world use of ceftolozane/tazobactam: a systematic literature review

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