Successful treatment of multidrug-resistant Pseudomonas aeruginosa breakthrough bacteremia with ceftolozane/tazobactam

Hernández-Tejedor, A.; Merino-Vega, Carmen Débora; Martín-Vivas, A; Luna-González, Rafael Ruiz de; Delgado‐Iribarren, Alberto; Gabán-Díez, Á.; Temprano-Gómez, I.; Calle-Pedrosa, N. De la; González-Jiménez, Ana Isabel; Algora-Weber, A.

doi:10.1007/s15010-016-0944-5

Cited by 20 publications

(24 citation statements)

References 4 publications

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“…There are published data on the use of ceftolozane-tazobactam for the treatment of severe infections caused by MDR P. aeruginosa [119,[222][223][224][225].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Aguado

Silva

Fernández‐Ruiz

et al. 2018

Transplantation Reviews

124

139

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Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection.

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“…There are published data on the use of ceftolozane-tazobactam for the treatment of severe infections caused by MDR P. aeruginosa [119,[222][223][224][225].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Aguado

Silva

Fernández‐Ruiz

et al. 2018

Transplantation Reviews

124

139

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“…To overcome this problem, new antibiotics, such as ceftolozane-tazobactam (C-T), which can be an effective and safe alternative for the treatment of MDRPA infections (5,6), were recently developed. C-T is a new combination of an antipseudomonal cephalosporin and a beta-lactamase inhibitor.…”

mentioning

confidence: 99%

Salvage Therapy with Ceftolozane-Tazobactam for Multidrug-Resistant Pseudomonas aeruginosa Infections

Castón

Torre

Ruiz‐Camps

et al. 2017

Antimicrob Agents Chemother

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Infections caused by multidrug-resistant Pseudomonas aeruginosa (MDRPA) present a major problem for therapeutic management. We report here our experience with 12 patients with a severe MDRPA infection (6 of which were pneumonia) who received salvage therapy with ceftolozane-tazobactam after inappropriate empirical treatment and/or suboptimal targeted treatment. Although 10 of the 12 patients (83.3%) experienced septic shock, only 3 patients (25%) died during the follow-up period. Microbiological cure in 7 patients (58.3%) was observed.

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“…Eight studies reported that 57 patients with RTIs were admitted to the ICU. 16,21,29,32,34,35,39,45 The majority of these studies were either single patient case reports (6 studies), 21,29,32,34,35,39 or a case series comprising two patients. 16 One larger study -conducted in patients with RTIs onlyreported that 49 patients (of 62 recruited; 79.0%) were admitted to the ICU.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…44 Twelve studies reported 74 patients that were immunocompromised. 17,20,[25][26][27][28][29]39,40,42,43,45 Of these studies, two included only immunocompromised patients. 28,43 As with ICU patients, this is likely an underestimation as most multi-infection studies did not provide a breakdown by infection type.…”

Section: Study Characteristicsmentioning

confidence: 99%

Systematic Literature Review of Real-World Evidence of C Eftolozane/Tazobactam for the Treatment of Respiratory Infections

Puzniak

Dillon

Palmer³

et al. 2021

Preprint

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Background: Gram-negative nosocomial pneumonia (NP), including hospital-acquired bacterial pneumonia (HABP), ventilated HABP (vHABP), and ventilator-associated bacterial pneumonia (VABP), is a significant cause of morbidity and mortality. Common pathogens, including Enterobacterales and Pseudomonas aeruginosa are highly prevalent in healthcare settings and have few effective treatment options due to high rates of antibacterial resistance. Resistant pathogens are associated with significantly worse outcomes and higher costs, relative to patients with susceptible infections. Ceftolozane/tazobactam (C/T) has established efficacy in clinical trials of patients with NP. This review aimed to collate data on C/T use for HABP/vHABP/VABP infections in real-world clinical practice. Methods: This systematic literature review searched online biomedical databases for real-world studies of C/T for gram-negative respiratory tract infections (RTIs) up to June 2020. Relevant study, patient, and treatment characteristics, microbiology, and efficacy outcomes were captured.Results: Thirty-three studies comprising 658 patients were identified. Pneumonia was the most common infection C/T was used to treat (85%), with a smaller number of unspecified RTIs (9%) and tracheobronchitis (5%) reported. Data on severity of illness and comorbidity were inconsistently reported. The majority of patients had respiratory infections caused by P. aeruginosa (92.8%), of which 88.1% were multidrug-resistant (including extensively drug-resistant or pandrug-resistant). Examination of these studies demonstrated an increase in the percentage of patients receiving the recommended dose of C/T for respiratory infections (3 g q8h or renal impairment-adjusted) over time (36.8% of patients in 2017 to 71.5% in 2020). Clinical success rates ranged from 51.4–100%, with 10 studies (55.6% of studies reporting clinical success) reporting clinical success rates of >70%; microbiological success rates ranged from 57.0–100.0%, with three studies (60.0% of studies reporting microbiological success) reporting microbiological success rates of >70%. Thirty-day mortality ranged from 0.0–33.0%, with nine studies (90% of studies reporting mortality) reporting 30-day mortality of <30%. Conclusions: The studies identified in this review demonstrate that C/T shows similar outcomes as those seen in clinical trials, despite the higher frequency of multidrug-resistant pathogens, and comorbidities/conditions that may have been excluded from the trials.

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Successful treatment of multidrug-resistant Pseudomonas aeruginosa breakthrough bacteremia with ceftolozane/tazobactam

Abstract: We describe the use of off-label ceftolozane/tazobactam in the management of a multidrug-resistant Pseudomonas aeruginosa bacteremia that was already being treated with colistin and amikacin, the only active antibiotics according to the antibiogram.

Cited by 20 publications

References 4 publications

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Salvage Therapy with Ceftolozane-Tazobactam for Multidrug-Resistant Pseudomonas aeruginosa Infections

Systematic Literature Review of Real-World Evidence of C Eftolozane/Tazobactam for the Treatment of Respiratory Infections

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