Article (Scientific journals)
Continuous infusion, therapeutic drug monitoring and outpatient parenteral antimicrobial therapy with ceftazidime/avibactam: a retrospective cohort study.
GONCETTE, Véronique; Layios, Nathalie; DESCY, Julie et al.
2021In Journal of Global Antimicrobial Resistance, 26, p. 15 - 19
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Keywords :
Ceftazidime/avibactam; Continuous infusion; Multidrug-resistant infection; Outpatient parenteral antimicrobial therapy; Therapeutic drug monitoring
Abstract :
[en] [en] OBJECTIVES: Based on recent pharmacokinetic/pharmacodynamic (PK/PD) evidence, continuous-infusion (CI) β-lactam administration is increasingly recommended for serious infections. Since 2016, the combination ceftazidime/avibactam (CAZ/AVI) is administered as per the manufacturer's instructions as an intermittent infusion of 2.5 g every 8 h. Thus, CI has not yet been evaluated in clinical trials. METHODS: We aimed to evaluate the use of CI of CAZ/AVI in a retrospective case series from December 2016 to October 2019. All isolates displayed in vitro susceptibility to CAZ/AVI according to EUCAST definitions. Patients were initially given CAZ/AVI as CI of 5 g every 12 h, and dosages were adjusted according to therapeutic drug monitoring of ceftazidime with a therapeutic goal of ≥4-5 × MIC in plasma and/or at the site of infection. RESULTS: CAZ/AVI was administered by CI in 10 patients with infections mainly caused by multidrug-resistant Pseudomonas aeruginosa (54.5%) and Klebsiella pneumoniae (36.4%). Bacteraemia occurred in 30% of cases. Sepsis or septic shock was present in 20% of cases. CAZ/AVI was used as monotherapy in 60% of cases. Clinical cure and microbiological eradication were achieved in 80% and 90% of cases, respectively. The 30-day mortality after CAZ/AVI treatment onset was 10%. The therapeutic goals of ≥4-5 × MIC in plasma and/or at the site of infection were achieved in 100% and 87.5% of cases, respectively, without adverse events. CONCLUSION: Despite a limited number of patients, CI of CAZ/AVI provided promising results after optimisation of PK/PD parameters both in plasma and at the site of infection.
Disciplines :
Immunology & infectious disease
Author, co-author :
GONCETTE, Véronique ;  Centre Hospitalier Universitaire de Liège - CHU > > Service officine et gaz médicaux
Layios, Nathalie  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service des soins intensifs
DESCY, Julie ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de microbiologie clinique
FRIPPIAT, Frédéric  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service des maladies infectieuses - médecine interne
Language :
English
Title :
Continuous infusion, therapeutic drug monitoring and outpatient parenteral antimicrobial therapy with ceftazidime/avibactam: a retrospective cohort study.
Publication date :
September 2021
Journal title :
Journal of Global Antimicrobial Resistance
ISSN :
2213-7165
eISSN :
2213-7173
Publisher :
Elsevier Ltd, Netherlands
Volume :
26
Pages :
15 - 19
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 12 May 2023

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