TABLE 10.
Studies evaluating ceftolozane-tazobactam for P. aeruginosa infections
| Study ID; main pathogen (reference) | Designa | No. included (p/i)b | No. and source(s) of infectionc | No. of P. aeruginosa isolates by type | No. of P. aeruginosa isolates by susceptibilityd | No. of isolates with combination treatment | Outcomes (no. [%])e |
|---|---|---|---|---|---|---|---|
| Miller 2016; any P. aeruginosa (319) | Post hoc analysis of RCT (142) (C-T + M vs Mero) | 26 p C-T, 29 p Mero | IAI | 26 i C-T, 29 i Mero | MDR, 3 i Mero arm | No | Clinical cure TOC: C-T, 26/26 (100); Mero, 27/29 (93.1) |
| Caston 2017; MDR P. aeruginosa (164) | Case series, salvage therapy with C-T | 12 p | 6 LRTI, 5 BSI, 3 IAI, 3 others | MDR | NSf |
Mortality: 3/12 (25) Clinical cure 30 days: 9/12 (75) Microbiol cure 30 days: 7/12 (58.3) |
|
| Dinh 2017; XDR P. aeruginosa (320) | Case series, salvage therapy with C-T | 15 p (14 adults, 1 child) | 7 LRTI, 3 UTI, 2 IAI, 3 others | XDR | 10 |
Mortality: 4/15 (27) Clinical cure EOT: 10/15 (67) Microbiol cure EOT: 6/8 (75) |
|
| Haidar 2017; MDR P. aeruginosa (130) | Retrospective study | 21 p | 18 LRTI, 1 BSI, 1 UTI, 1 IAI | MDR, 15 XDR | 16 |
Mortality: 2/21 (10) Clinical success 90 days: 15/21 (71.4) |
|
| Munita 2017; CR P. aeruginosa (321) | Retrospective study | 35 p | 18 LRTI, 6 BSI | CR | 8 |
Mortality: 8/35 (22.3) Clinical success in hospital: 26/35 (74) Microbiol success in hospital: 25/25 |
|
| Diaz-Cañestro 2018; MDR XDR P. aeruginosa (165) | Prospective observational study | 58 p | 35 LRTI, 10 UTI, 4 IAI, 6 other, 3 BSI | 6 MDR, 50 XDR | 37 |
Mortality: 16/58 (27.6) Clinical cure 7 days: 37/58 (63.8) Microbiol cure 7 days: 21/30 (70) |
|
| Escola-Verge 2018; XDR P. aeruginosa (166) | Retrospective study | 38 p | 14 LRTI, 6 UTI, 6 SSTI, 4 IAI, 8 other, 11 BSI | XDR | 24 |
Mortality: 5/38 (13.2) Clinical response EOT: 33/38 (86.8); 90 days, 26/38 (68.4) Microbiol cure 90 days: 26/38 (68.4) |
|
| Gallagher 2018; MDR P. aeruginosa (147) | Retrospective | 205 p | 121 LRTI, 28 UTI, 20 IAI, 25 BSI, 42 others | 205 p | 205 MDR (96.8% CR) | 81 |
Mortality: 39/205 (19) Clinical success EOT: 151/205 (73.7) Microbiol cure EOT: 145/205 (70.7) |
| Xipell 2018; MDR P. aeruginosa (163) | Case series, salvage therapy with C-T | 23 p, 24 e | 8 LRTI, 7 UTI, 6 SSTI, 3 IAI | 4 MDR, 19 XDR, 1 PDR | 16 |
Mortality: 5/23 (22) Clinical cure: 21/24 (88) Microbiol cure: 12/16 |
|
| Bassetti 2019; Any P. aeruginosa (158) | Retrospective study | 101 p | 32 LRTI, 21 SSTI, 14 UTI, 13 IAI, 6 other, 22 BSI | 30 non-MDR, 18 MDR, 51 XDR, 2 PDR | 36 |
Mortality: 5/101 (5) Clinical success EOT: 84/101 (83.2) |
|
| Pogue 2019; MDR/XDR P. aeruginosa (145) | Retrospective comparative study | 200 p: 100 p C-T, 100 p polymyxin or aminoglycoside-based regimen | C-A: 64 LRTI, 16 UTI, 13 SSTI, 7 other, 6 BSI; comp: 75 LRTI, 11 UTI, 6 SSTI, 6 other, 6 BSI | MDR XDR | 15 |
Mortality: C-T, 20/100 (20); comp, 25/100 (25) Clinical cure on therapy: C-T, 81/100 (81); comp, 61/100 (61) |
|
| Vena 2019; MDR/XDR P. aeruginosa (146) | Case control | 48 p: 16 p C-T, 32 p colistin/aminoglycoside | 27 LRTI, 21 BSI | 30 MDR, 18 XDR | 9 C-T, 29 comp |
Mortality: C-T, 3/16 (18.8%); comp, 9/32 (28.1) Clinical cure 14 days: C-T, 13/16 (81.3), comp, 18/32 (56.3) |
a
RCT, randomized controlled trial; M, metronidazole; Mero, meropenem; C-T, ceftolozane-tazobactam.
b
p, patients; i, isolate; e, episode.
c
IAI, intra-abdominal infection; LRTI, lower respiratory tract infection; BSI, bloodstream infection; UTI, urinary tract infection; SSTI, skin and soft tissue infection; comp, comparator.
d
MDR, multidrug resistant; XDR, extensively drug resistant; CR, carbapenem resistant; PDR, pandrug resistance.
e
Microbiol, microbiological; TOC, test of cure; EOT, end of treatment.
f
NS, nonspecified.