Ceftazidima-avibactam en el tratamiento de infecciones urinarias por Klebsiella productora de carbapenemasa en trasplante renal

Caravaca-Fontán, Fernando; Jiménez-Álvaro, Sara; Marcén-Letosa, Roberto; Fernández-Rodríguez, Ana; Rodríguez-Navarro, Carlos Quereda

doi:10.1016/j.nefro.2015.01.001

Cited by 12 publications

(4 citation statements)

References 4 publications

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“…On day 15, BAL fluid was culture-negative. The patient was transferred to the ward 3 weeks after his second ICU admission and was discharged home 10 days later Carannante 2018 [ 70 ] Bangladeshi male migrant from Libya (age NR), cellulitis with KPC-KP No KPC-KP Dose NR, 10 days After 10 days of treatment, cultures and molecular tests resulted negative both from ulcers and rectal swabs Caravaca-Fontán 2015 [ 71 ] 78-year-old male kidney transplant recipient, recurring UTI No KPC-KP 1.25 g q12h, 2 weeks Definitive eradication of the urinary infection as well as the KPC carrier state Daccò 2019 [ 72 ] 32-year-old female with lung transplantation due to CF, post-surgery bacteraemia and brain abscesses Comorbidities including diabetes, ESRD on HD Yes B. multivorans 2.5 g q24h (after HD), added on day 19, increased to 2.5 g q12h on day 33, continued to day 129 The patient was discharged on day 135. Brain MRIs 1 and 4 months later documented an almost complete resolution of the parenchymal abscesses.…”

Section: Resultsmentioning

confidence: 99%

Ceftazidime-Avibactam for the Treatment of Serious Gram-Negative Infections with Limited Treatment Options: A Systematic Literature Review

et al. 2021

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Introduction A systematic literature review was undertaken to evaluate real-world use of ceftazidime-avibactam for infections due to aerobic Gram-negative organisms in adults with limited treatment options. Methods Literature searches retrieved peer-reviewed publications and abstracts from major international infectious disease congresses from January 2015 to February 2021. Results were screened using pre-defined criteria to limit the dataset to relevant publications (notable exclusions were paediatric data and outcomes data for bacteria intrinsically resistant to ceftazidime-avibactam). Data for included publications were subjected to qualitative synthesis. Results Seventy-three relevant publications (62 peer-reviewed articles; 10 abstracts) comprising 1926 patients treated with ceftazidime-avibactam (either alone or combined with other antimicrobials) and 1114 comparator/control patients were identified. All patients were hospitalised for serious illness and most had multiple comorbidities. The most common infections were pneumonia, bacteraemia, and skin/soft tissue, urinary tract, or abdominal infections; smaller numbers of patients with meningitis, febrile neutropenia, osteomyelitis, and cystic fibrosis were also included. Carbapenem-resistant or carbapenemase-producing Enterobacterales (CRE; n = 1718) and carbapenem-resistant, multidrug-resistant (MDR), and extensively drug-resistant Pseudomonas aeruginosa ( n = 150) were the most common pathogens. Most publications reported positive outcomes for ceftazidime-avibactam treatment (clinical success rates ranged from 45 to 100% and reported 30-day mortality from 0 to 63%), which were statistically superior versus comparators in some studies. ceftazidime-avibactam resistance emergence occurred infrequently and mostly in Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae strains. Conclusion This review provides qualitative evidence of successful use of ceftazidime-avibactam for the treatment of hospitalised patients with CRE and MDR P. aeruginosa infections with limited treatment options. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00507-6.

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Section: Resultsmentioning

confidence: 99%

Ceftazidime-Avibactam for the Treatment of Serious Gram-Negative Infections with Limited Treatment Options: A Systematic Literature Review

et al. 2021

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“…Ceftazidime–avibactam has shown potent in vitro activity against CRE isolates [ 61 – 63 ]. and there have also been reports that ceftazidime–avibactam is effective for CPKP infections after other combination regimens have failed [ 19 , 64 , 65 ]. Other β-lactam/β-lactamase inhibitor combinations are also being investigated including ceftolozane–tazobactam and aztreonam–avibactam [ 12 , 66 ].…”

Section: Discussionmentioning

confidence: 99%

Triple combination antibiotic therapy for carbapenemase-producing Klebsiella pneumoniae: a systematic review

Jacobs

Safir

Huang

et al. 2017

Ann Clin Microbiol Antimicrob

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BackgroundThe spread of carbapenemase-producing K. pneumoniae (CPKP) has become a significant problem worldwide. Combination therapy for CPKP is encouraging, but polymyxin resistance to many antibiotics is hampering effective treatment. Combination therapy with three or more antibiotics is being increasingly reported, therefore we performed a systematic review of triple combination cases in an effort to evaluate their clinical effectiveness for CPKP infections.MethodsThe PubMed database was searched to identify all published clinical outcomes of CPKP infections treated with triple combination therapy. Articles were stratified into two tiers depending on the level of clinical detail provided. A tier 1 study included: antibiotic regimen, regimen-specific outcome, patient status at onset of infection, and source of infection. Articles not reaching these criteria were considered tier 2.ResultsThirty-three studies were eligible, 23 tier 1 and ten tier 2. Among tier 1 studies, 53 cases were included in this analysis. The most common infection was pneumonia (31%) followed by primary or catheter-related bacteremia (21%) and urinary tract infection (17%). Different combinations of antibiotic classes were utilized in triple combinations, the most common being a polymyxin (colistin or polymyxin B, 86.8%), tigecycline (73.6%), aminoglycoside (43.4%), or carbapenem (43.4%). Clinical and microbiological failure occurred in 14/39 patients (35.9%) and 22/42 patients (52.4%), respectively. Overall mortality for patients treated with triple combination therapy was 35.8% (19/53 patients).ConclusionsTriple combination therapy is being considered as a treatment option for CPKP. Polymyxin-based therapy is the backbone antibiotic in these regimens, but its effectiveness needs establishing in prospective clinical trials.

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“…However, the experience with these molecules in real-life settings is still scarce, as is the evidence of their superiority versus old schemes [83][84][85]. Data are even more scarce in the setting of SOTRs, as they are mainly limited to small series rather than large cohorts [10,[86][87][88]. Ceftazidime/avibactam inhibits the activity of class A and D carbapenemases, including KPC and OXA 48, but it is not active against class B carbapenemases.…”

Section: Management Of Lung Infections In Solid Organ Transplant Recimentioning

confidence: 99%

“…Specifically, in SOTRs, this overuse contributes to the development of infections by multidrug-resistant (MDR) Gram-negative pathogens. In several studies performed among solid organ transplant recipients in Western countries, multidrug resistance was frequently encountered in the setting of Gram-negative bloodstream infections [5][6][7][8][9][10]. Of note, a study performed by Linares et al in Spain reported the detection of extended-spectrum beta-lactamases in 54% of the Escherichia coli bacteremia episodes, while Johnson et al detected the presence of multidrug resistance in 43% of the Pseudomonas aeruginosa bloodstream infections reported in a large US transplant center [5,9].…”

Section: Introductionmentioning

confidence: 99%

Challenges in the Diagnosis and Management of Bacterial Lung Infections in Solid Organ Recipients: A Narrative Review

Carugati

Morlacchi

Peri

et al. 2020

IJMS

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Respiratory infections pose a significant threat to the success of solid organ transplantation, and the diagnosis and management of these infections are challenging. The current narrative review addressed some of these challenges, based on evidence from the literature published in the last 20 years. Specifically, we focused our attention on (i) the obstacles to an etiologic diagnosis of respiratory infections among solid organ transplant recipients, (ii) the management of bacterial respiratory infections in an era characterized by increased antimicrobial resistance, and (iii) the development of antimicrobial stewardship programs dedicated to solid organ transplant recipients.

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Ceftazidima-avibactam en el tratamiento de infecciones urinarias por Klebsiella productora de carbapenemasa en trasplante renal

Cited by 12 publications

References 4 publications

Ceftazidime-Avibactam for the Treatment of Serious Gram-Negative Infections with Limited Treatment Options: A Systematic Literature Review

Ceftazidime-Avibactam for the Treatment of Serious Gram-Negative Infections with Limited Treatment Options: A Systematic Literature Review

Triple combination antibiotic therapy for carbapenemase-producing Klebsiella pneumoniae: a systematic review

Challenges in the Diagnosis and Management of Bacterial Lung Infections in Solid Organ Recipients: A Narrative Review

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