Table 4. Clinical characteristics, microbiology data and outcome of patients treated with ceftolozane/tazobactam or ceftazidime/avibactam during the study period.
| patient | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | |
|---|---|---|---|---|---|---|---|---|---|
| Age | 23 | 43 | 51 | 61 | 52 | 45 | 57 | 56 | |
| Sex | f | m | m | m | m | m | m | m | |
| underlying condition | CF | lung transplant, PAH | liver transplant, SSC | esophago-tracheal fistula | AML | CHF, complicated duodeno-spleno-pancreatectomy (duodenal ulcer) |
esophageal cancer, thoracoabdominal esophagectomy, gastric pull-up | chronic IBD | |
|
infection due to MDR-GNB |
CAP/HAP | HAP | HAP, cholangitis | HAP | bacteremia | HAP | HAP | cIAI, HAP | |
| species | P. aeruginosa | P. aeruginosa | P. aeruginosa | K. pneumoniae | K. pneumoniae | K. pneumoniae | K. pneumoniae | K. pneumoniae | |
|
β-lactam resistance genes |
none detected | none detected | none detected | blaOXA-48, blaCTX-M-14 |
blaOXA-48, blaCTX-M-14 |
blaOXA-48, blaCTX-M-14 |
blaOXA-48, blaCTX-M-14 |
blaOXA-48, blaCTX-M-14 |
|
| Drug | TOL/TZB | TOL/TZB | TOL/TZB | CAZ/AVI | CAZ/AVI | CAZ/AVI | CAZ/AVI | CAZ/AVI | |
| dose (g) | 1/0.5 q8h | 1/0.5 q12h to 2/1 q8h |
2/1 q8h | 2/0.5 q8h | 2/0.5 q8h | 2/0.5 q8h | 2/0.5 q8h | 2/0.5 q8h | |
| total treatment duration (days) | 19 | 51 (2 courses) | 12 (2 courses) | 2 | 57 | 86 (4 courses) | 8 | 61 (3 courses) | |
| MICs of last isolate before treatment (mg/L) | TOL/TZB | 1 | 2 | 0.38 | 16 | >256 | 16 | >256 | >256 |
| CAZ/AVI | 4 | 16 | 4 | 0,5 | 0.75 | 0.125 | 2 | 1 | |
| PIP | >256 | 32 | 16 | >256 | >256 | >256 | >256 | >256 | |
| MEM | >32 | >32 | >32 | >32 | >32 | >32 | 16 | >32 | |
| CAZ | 32 | 16 | 16 | >256 | >256 | 4 | >256 | >256 | |
| CIP | 4 | 4 | 1 | >32 | >32 | >32 | >32 | >32 | |
| COL | 0.125 | 1 | 0.75 | 16 | 0.25 | 0.25 | 2 | 16 | |
| MICs of last available isolate (mg/L) | TOL/TZB | >256 | >256 | 8 | n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. |
n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. |
12 | n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. n.a. |
>256 |
| CAZ/AVI | >256 | >256 | 16 | 0.75 | 32 | ||||
| PIP | >256 | >256 | >256 | >256 | >256 | ||||
| MEM | >32 | >32 | >32 | >32 | >32 | ||||
| CAZ | >256 | >256 | 32 | 4 | >256 | ||||
| CIP | >32 | 4 | 2 | >32 | >32 | ||||
| COL | 8 | 1 | 2 | 0.25 | >16 | ||||
| Outcome | discharged | died under therapy | died under therapy | died under therapy | died under therapy | died under therapy |
died while hospitalized | died under therapy | |
Abbreviations: f, female; m, male; CF, cystic fibrosis; PAH, pulmonary arterial hypertension; SCC, secondary sclerosing cholangitis; AML, acute myeloid leukemia; CHF, congestive heart failure; IBD: inflammatory bowel disease; MDR-GNB, multidrug-resistant Gram-negative bacteria; CAP, community acquired pneumonia; HAP, hospital-acquired pneumonia; cIAI, complicated intra-abdominal infection; TOL/TZB, ceftolozane/tazobactam; CAZ/AVI, ceftazidime/avibactam; MIC, minimal inhibitory concentration; PIP, piperacillin; MEM, meropenem; CAZ, ceftazidime; CIP, ciprofloxacin; COL, colistin; n.a., not available