Subject(s)
Aerococcus , Endocarditis, Bacterial , Gram-Positive Bacterial Infections , Recurrence , Urinary Tract Infections , Humans , Urinary Tract Infections/microbiology , Urinary Tract Infections/diagnosis , Urinary Tract Infections/drug therapy , Aerococcus/isolation & purification , Endocarditis, Bacterial/microbiology , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/drug therapy , Gram-Positive Bacterial Infections/diagnosis , Gram-Positive Bacterial Infections/microbiology , Gram-Positive Bacterial Infections/drug therapy , MaleABSTRACT
Introduction Pseudomonas aeruginosa displays resistance to several available antibiotics. Infections caused by this pathogen are associated with a high mortality, morbidity, and considerable healthcare resource utilization and costs. This study was aimed at describing the use of ceftolozane/tazobactam (C/T) for the treatment of patients with P. aeruginosa infections. Methods Case series analysis of hospitalized patients treated with C/T for P. aeruginosa infections in five public Portuguese hospitals. Patients presenting with infections caused by this pathogen and receiving C/T for at least 72h during hospitalization were eligible. Results Sixty-four hospitalized patients with P. aeruginosa infections treated with C/T were evaluated between December 2016 and July 2019. Most patients were aged between 60 and 79 years (53.9%). Patients presented a total of 68 P. aeruginosa infections, with respiratory infections being the most common (28.1%, 18 out of 64). Most P. aeruginosa strains (85.9%, 55 out of 64) were extensively drug-resistant (XDR). C/T was mostly used as targeted therapy (98.4%, 63 out of 64 patients) and as monotherapy (72.7%, 47 out of 64 patients). Combination therapy was used in 47.4% (9 out of 19) of patients with bacteriemia. Most patients had successful microbiological (79.2%, 42 out of 53) and clinical (78.7%, 48 out of 61) outcomes. All-cause in-hospital mortality rate was 34.4%. Conclusion The present case series contributes to the body of evidence suggesting that C/T is an effective and safe option for treating P. aeruginosa infections, namely those caused by XDR strains, both when used as mono- or combination therapy (AU)
Introducción Pseudomonas aeruginosa presenta mecanismos de resistencia a diversos antibióticos. Las infecciones causadas por este patógeno aumentan la morbimortalidad, el uso de recursos y los costos asociados. Este estudio tuvo como objetivo describir el uso de ceftolozano/tazobactam (C/T) para el tratamiento de pacientes con infecciones por P. aeruginosa. Métodos Serie de casos de pacientes hospitalizados con infecciones por P. aeruginosa que fueron tratados con C/T en 5 hospitales portugueses. Fueron incluidos pacientes que presentaban infecciones por este patógeno y recibían terapéutica con C/T durante al menos 72 horas. Resultados Entre diciembre de 2016 y julio de 2019 fueron analizados 64 pacientes hospitalizados con infecciones por P. aeruginosa tratados con C/T. La mayoría tenían entre 60 y 79 años (53,9%). Se aislaron 68 infecciones por P. aeruginosa, siendo más frecuentes las respiratorias (28,1%; 18/64). La mayoría de las cepas de P. aeruginosa (85,9%; 55764) eran extremadamente resistentes. El C/T se utilizó principalmente como terapia dirigida (98,4%; 63/64 pacientes) y en monoterapia (72,7%; 47/64 pacientes). La terapia combinada se utilizó en el 47,4% (9/19) de los pacientes con bacteriemia. La mayoría de los pacientes tuvieron resultados microbiológicos (79,2%; 42/53) y clínicos (78,7%; 48/61) satisfactorios. La tasa de mortalidad intrahospitalaria por todas las causas fue del 34,4%. Conclusión La presente serie de casos sustenta que la terapéutica con C/T es una alternativa efectiva y segura para las infecciones por P. aeruginosa, particularmente por cepas extremadamente resistentes, en monoterapia o en terapia combinada (AU)
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Cross Infection/drug therapy , Cross Infection/microbiology , Pseudomonas Infections/drug therapy , Tazobactam/administration & dosage , Cephalosporins/administration & dosage , Anti-Bacterial Agents/administration & dosage , Drug Resistance, Multiple, Bacterial , Retrospective StudiesABSTRACT
INTRODUCTION: Pseudomonas aeruginosa displays resistance to several available antibiotics. Infections caused by this pathogen are associated with a high mortality, morbidity, and considerable healthcare resource utilization and costs. This study was aimed at describing the use of ceftolozane/tazobactam (C/T) for the treatment of patients with P. aeruginosa infections. METHODS: Case series analysis of hospitalized patients treated with C/T for P. aeruginosa infections in five public Portuguese hospitals. Patients presenting with infections caused by this pathogen and receiving C/T for at least 72h during hospitalization were eligible. RESULTS: Sixty-four hospitalized patients with P. aeruginosa infections treated with C/T were evaluated between December 2016 and July 2019. Most patients were aged between 60 and 79 years (53.9%). Patients presented a total of 68 P. aeruginosa infections, with respiratory infections being the most common (28.1%, 18 out of 64). Most P. aeruginosa strains (85.9%, 55 out of 64) were extensively drug-resistant (XDR). C/T was mostly used as targeted therapy (98.4%, 63 out of 64 patients) and as monotherapy (72.7%, 47 out of 64 patients). Combination therapy was used in 47.4% (9 out of 19) of patients with bacteriemia. Most patients had successful microbiological (79.2%, 42 out of 53) and clinical (78.7%, 48 out of 61) outcomes. All-cause in-hospital mortality rate was 34.4%. CONCLUSION: The present case series contributes to the body of evidence suggesting that C/T is an effective and safe option for treating P. aeruginosa infections, namely those caused by XDR strains, both when used as mono- or combination therapy.
