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Ceftazidime/avibactam in the era of carbapenemase-producing Klebsiella pneumoniae: experience from a national registry study.
Karaiskos, I; Daikos, G L; Gkoufa, A; Adamis, G; Stefos, A; Symbardi, S; Chrysos, G; Filiou, E; Basoulis, D; Mouloudi, E; Galani, L; Akinosoglou, K; Arvaniti, K; Masgala, A; Petraki, M; Papadimitriou, E; Galani, I; Poulakou, G; Routsi, C; Giamarellou, H.
Afiliación
  • Karaiskos I; Hygeia General Hospital, 1st Department of Internal Medicine - Infectious Diseases, Athens, Greece.
  • Daikos GL; Laiko General Hospital, 1st Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Gkoufa A; Laiko General Hospital, 1st Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Adamis G; Peripheral General Hospital Athens Giorgos Gennimatas, 1st Department of Internal Medicine and Infectious Diseases Unit, Athens, Greece.
  • Stefos A; University of Thessaly, Larissa, Department of Medicine and Research Laboratory of Internal Medicine, Larissa, Greece.
  • Symbardi S; Thriaseio Geniko Nosokomeio Elefsinas, 1st Department of Internal Medicine, Magoula of Elefsina, Athens, Greece.
  • Chrysos G; Peripheral General Hospital of Peiraias Tzaneio, 2nd Department of Internal Medicine and Infectious Diseases Unit, Athens, Greece.
  • Filiou E; Sotiria General Hospital of Chest Diseases of Athens, Intensive Care Unit, 1st Department of Respiratory Medicine, Athens, Greece.
  • Basoulis D; Laiko General Hospital, 1st Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Mouloudi E; Ippokrateio General Hospital of Thessaloniki, Intensive Care Unit, Thessaloniki, Greece.
  • Galani L; Hygeia General Hospital, 1st Department of Internal Medicine - Infectious Diseases, Athens, Greece.
  • Akinosoglou K; University of Patras, Department of Medicine, Medical School, Patras, Greece.
  • Arvaniti K; Geniko Nosokomeio Thessalonikis Papageorgiou, Intensive Care Unit and Antimicrobial Stewardship Unit, Thessaloniki, Greece.
  • Masgala A; Konstantopouleio General Hospital Neas Ionias Patesion, 1st Department of Internal Medicine, Athens, Greece.
  • Petraki M; Mediterraneo Hospital, Intensive Care Unit, Athens, Greece.
  • Papadimitriou E; General Hospital of Lamia, Department of Internal Medicine, Lamia, Greece.
  • Galani I; National and Kapodistrian University of Athens Faculty of Medicine, Infectious Diseases Laboratory, 4th Department of Internal Medicine, Athens, Greece.
  • Poulakou G; Sotiria General Hospital of Chest Diseases of Athens, 3rd Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
  • Routsi C; Evaggelismos Hospital, Intensive Care Unit, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Giamarellou H; Hygeia General Hospital, 1st Department of Internal Medicine - Infectious Diseases, Athens, Greece.
J Antimicrob Chemother ; 76(3): 775-783, 2021 02 11.
Article en En | MEDLINE | ID: mdl-33249436
BACKGROUND: Infections caused by KPC-producing Klebsiella pneumoniae (Kp) are associated with high mortality. Therefore, new treatment options are urgently required. OBJECTIVES: To assess the outcomes and predictors of mortality in patients with KPC- or OXA-48-Kp infections treated with ceftazidime/avibactam with an emphasis on KPC-Kp bloodstream infections (BSIs). METHODS: A multicentre prospective observational study was conducted between January 2018 and March 2019. Patients with KPC- or OXA-48-Kp infections treated with ceftazidime/avibactam were included in the analysis. The subgroup of patients with KPC-Kp BSIs treated with ceftazidime/avibactam was matched by propensity score with a cohort of patients whose KPC-Kp BSIs had been treated with agents other than ceftazidime/avibactam with in vitro activity. RESULTS: One hundred and forty-seven patients were identified; 140 were infected with KPC producers and 7 with OXA-48 producers. For targeted therapy, 68 (46.3%) patients received monotherapy with ceftazidime/avibactam and 79 (53.7%) patients received ceftazidime/avibactam in combination with at least another active agent. The 14 and 28 day mortality rates were 9% and 20%, respectively. The 28 day mortality among the 71 patients with KPC-Kp BSIs treated with ceftazidime/avibactam was significantly lower than that observed in the 71 matched patients, whose KPC-Kp BSIs had been treated with agents other than ceftazidime/avibactam (18.3% versus 40.8%; P = 0.005). In the Cox proportional hazards model, ultimately fatal disease, rapidly fatal disease and Charlson comorbidity index ≥2 were independent predictors of death, whereas treatment with ceftazidime/avibactam-containing regimens was the only independent predictor of survival. CONCLUSIONS: Ceftazidime/avibactam appears to be an effective treatment against serious infections caused by KPC-Kp.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por Klebsiella / Ceftazidima / Compuestos de Azabiciclo / Klebsiella pneumoniae / Antibacterianos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: J Antimicrob Chemother Año: 2021 Tipo del documento: Article País de afiliación: Grecia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por Klebsiella / Ceftazidima / Compuestos de Azabiciclo / Klebsiella pneumoniae / Antibacterianos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Humans Idioma: En Revista: J Antimicrob Chemother Año: 2021 Tipo del documento: Article País de afiliación: Grecia Pais de publicación: Reino Unido