Clinical Efficacy of Ceftazidime-Avibactam in the Treatment of Infections Caused by Carbapenem–Resistant Gram-Negative Bacteria
The wide spread of carbapenemases among gram-negative bacteria of the Enterobacterales order in hospitals around the world, including Russia, creates great difficulties in the effective use of antibiotics for these infections in the ICU. Ceftazidime-avibactam is the first antibiotic developed and st...
Saved in:
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
LLC "Publishing House OKI"
2021-10-01
|
| Series: | Антибиотики и Химиотерапия |
| Subjects: | |
| Online Access: | https://www.antibiotics-chemotherapy.ru/jour/article/view/841 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849693099718082560 |
|---|---|
| author | S. V. Yakovlev |
| author_facet | S. V. Yakovlev |
| author_sort | S. V. Yakovlev |
| collection | DOAJ |
| description | The wide spread of carbapenemases among gram-negative bacteria of the Enterobacterales order in hospitals around the world, including Russia, creates great difficulties in the effective use of antibiotics for these infections in the ICU. Ceftazidime-avibactam is the first antibiotic developed and studied for the treatment of infections caused by carbapenem-resistant enterobacteria. Ceftazidime-avibactam shows high activity against producers of class A and D serine carbapenemases (KPC and OXA-48). In combination with aztreonam it is effective in infections caused by producers of class B metallo-beta-lactamases (NDM and VIM). The review analyzes the results of 19 non-comparative and 10 comparative studies of ceftazidime-avibactam in infections caused by carbapenem-resistant Enterobacterales, as well as case reports. According to the data of non- comparative studies, the clinical efficacy of ceftazidime-avibactam ranged from 45.0 to 87.2%, on average 71.7±11.3%, and the eradication rate of KPC or OXA-48 carbapenemase producers ranged from 40.0 to 100%, on average 65.5±18.6%. The effectiveness of ceftazidime-avibactam in comparative studies was 67.9±17.3%, which was significantly higher compared to other antibiotics (44.3±14.4%, P=0.012). Treatment with ceftazidime-avibactam was accompanied by a significantly lower 30-day mortality in contrast to other antibiotics – 23.8±13.5% and 41.0±13.6%, respectively, P=0.001. The development of resistance in Enterobacterales species to ceftazidime-avibactam during therapy is rarely observed, on average 5.4±4.4%, which characterizes a rather low potential of the antibiotic in resistance selection. Early administration of ceftazidime-avibactam is accompanied by better treatment results as opposed to delayed therapy. Treatment of infections caused by carbapenem-resistant enterobacteria with ceftazidime-avibactam is associated with a significantly higher recovery rate and a lower mortality compared to other regimens of antibacterial therapy. |
| format | Article |
| id | doaj-art-816a88320b8b41d78fd3e95bae42689d |
| institution | DOAJ |
| issn | 0235-2990 |
| language | Russian |
| publishDate | 2021-10-01 |
| publisher | LLC "Publishing House OKI" |
| record_format | Article |
| series | Антибиотики и Химиотерапия |
| spelling | doaj-art-816a88320b8b41d78fd3e95bae42689d2025-08-20T03:20:31ZrusLLC "Publishing House OKI"Антибиотики и Химиотерапия0235-29902021-10-01667-8678210.37489/0235-2990-2021-66-7-8-67-82800Clinical Efficacy of Ceftazidime-Avibactam in the Treatment of Infections Caused by Carbapenem–Resistant Gram-Negative BacteriaS. V. Yakovlev0I. M. Sechenov First Moscow State Medical University (Sechenov University); Clinical Hospital named after CC YudinThe wide spread of carbapenemases among gram-negative bacteria of the Enterobacterales order in hospitals around the world, including Russia, creates great difficulties in the effective use of antibiotics for these infections in the ICU. Ceftazidime-avibactam is the first antibiotic developed and studied for the treatment of infections caused by carbapenem-resistant enterobacteria. Ceftazidime-avibactam shows high activity against producers of class A and D serine carbapenemases (KPC and OXA-48). In combination with aztreonam it is effective in infections caused by producers of class B metallo-beta-lactamases (NDM and VIM). The review analyzes the results of 19 non-comparative and 10 comparative studies of ceftazidime-avibactam in infections caused by carbapenem-resistant Enterobacterales, as well as case reports. According to the data of non- comparative studies, the clinical efficacy of ceftazidime-avibactam ranged from 45.0 to 87.2%, on average 71.7±11.3%, and the eradication rate of KPC or OXA-48 carbapenemase producers ranged from 40.0 to 100%, on average 65.5±18.6%. The effectiveness of ceftazidime-avibactam in comparative studies was 67.9±17.3%, which was significantly higher compared to other antibiotics (44.3±14.4%, P=0.012). Treatment with ceftazidime-avibactam was accompanied by a significantly lower 30-day mortality in contrast to other antibiotics – 23.8±13.5% and 41.0±13.6%, respectively, P=0.001. The development of resistance in Enterobacterales species to ceftazidime-avibactam during therapy is rarely observed, on average 5.4±4.4%, which characterizes a rather low potential of the antibiotic in resistance selection. Early administration of ceftazidime-avibactam is accompanied by better treatment results as opposed to delayed therapy. Treatment of infections caused by carbapenem-resistant enterobacteria with ceftazidime-avibactam is associated with a significantly higher recovery rate and a lower mortality compared to other regimens of antibacterial therapy.https://www.antibiotics-chemotherapy.ru/jour/article/view/841carbapenem-resistant gram-negative bacteriainfectionsicuclinical effectivenessceftazidime–avibactam |
| spellingShingle | S. V. Yakovlev Clinical Efficacy of Ceftazidime-Avibactam in the Treatment of Infections Caused by Carbapenem–Resistant Gram-Negative Bacteria Антибиотики и Химиотерапия carbapenem-resistant gram-negative bacteria infections icu clinical effectiveness ceftazidime–avibactam |
| title | Clinical Efficacy of Ceftazidime-Avibactam in the Treatment of Infections Caused by Carbapenem–Resistant Gram-Negative Bacteria |
| title_full | Clinical Efficacy of Ceftazidime-Avibactam in the Treatment of Infections Caused by Carbapenem–Resistant Gram-Negative Bacteria |
| title_fullStr | Clinical Efficacy of Ceftazidime-Avibactam in the Treatment of Infections Caused by Carbapenem–Resistant Gram-Negative Bacteria |
| title_full_unstemmed | Clinical Efficacy of Ceftazidime-Avibactam in the Treatment of Infections Caused by Carbapenem–Resistant Gram-Negative Bacteria |
| title_short | Clinical Efficacy of Ceftazidime-Avibactam in the Treatment of Infections Caused by Carbapenem–Resistant Gram-Negative Bacteria |
| title_sort | clinical efficacy of ceftazidime avibactam in the treatment of infections caused by carbapenem resistant gram negative bacteria |
| topic | carbapenem-resistant gram-negative bacteria infections icu clinical effectiveness ceftazidime–avibactam |
| url | https://www.antibiotics-chemotherapy.ru/jour/article/view/841 |
| work_keys_str_mv | AT svyakovlev clinicalefficacyofceftazidimeavibactaminthetreatmentofinfectionscausedbycarbapenemresistantgramnegativebacteria |