PDF(Pubmed)
Abstract：
Ceftolozane-tazobactam (C-T) and ceftazidime-avibactam (CAZ-AVI) are two novel antimicrobials that retain activity against resistant Pseudomonas aeruginosa. The comparative effectiveness and safety of C-T versus CAZ-AVI remain unknown. A retrospective, multicenter cohort study was performed in six tertiary centers in Saudi Arabia and included patients who received either C-T or CAZ-AVI for infections due to multidrug-resistant (MDR) P. aeruginosa. Overall in-hospital mortality, 30-day mortality, and clinical cure were the main study outcomes. Safety outcomes were also evaluated. A multivariate analysis using logistic regression was used to determine the independent impact of treatment on the main outcomes of interest. We enrolled 200 patients in the study (100 in each treatment arm). A total of 56% were in the intensive care unit, 48% were mechanically ventilated, and 37% were in septic shock. Approximately 19% of patients had bacteremia. Combination therapy was administered to 41% of the patients. The differences between the C-T and CAZ-AVI groups did not reach statistical significance in the overall in-hospital mortality (44% versus 37%; P = 0.314; OR, 1.34; 95% CI, 0.76 to 2.36), 30-day mortality (27% versus 23%; P = 0.514; OR, 1.24; 95% CI, 0.65 to 2.35), clinical cure (61% versus 66%; P = 0.463; OR, 0.81; 95% CI, 0.43 to 1.49), or acute kidney injury (23% versus 17%; P = 0.289; OR, 1.46; 95% CI, 0.69 to 3.14), even after adjusting for differences between the two groups. C-T and CAZ-AVI did not significantly differ in terms of safety and effectiveness, and they serve as potential options for the treatment of infections caused by MDR P. aeruginosa.
摘要：
头孢洛扎-他唑巴坦（C-T）和头孢他啶-阿维巴坦（CAZ-AVI）是两种新型的抗微生物剂，对耐药性铜绿假单胞菌具有活性。C-T与CAZ-AVI的比较有效性和安全性仍然未知。回顾，多中心队列研究在沙特阿拉伯的6个三级中心进行,纳入因多重耐药(MDR)铜绿假单胞菌感染而接受C-T或CAZ-AVI治疗的患者.住院总死亡率，30天死亡率，临床治愈是主要研究结果。还评估了安全性结果。使用逻辑回归的多变量分析用于确定治疗对感兴趣的主要结局的独立影响。我们在研究中招募了200名患者(每个治疗组中有100名)。共有56%的人在加护病房,48%采用机械通气,37％的患者为感染性休克。大约19%的患者有菌血症。41%的患者接受了联合治疗。C-T组和CAZ-AVI组的总体住院死亡率差异无统计学意义(44%对37%;P=0.314;OR,1.34；95%CI，0.76至2.36），30天死亡率（27%对23%；P=0.514；OR，1.24；95%CI，0.65至2.35），临床治愈（61%对66%；P=0.463；OR，0.81；95%CI，0.43至1.49），或急性肾损伤(23%对17%；P=0.289；OR，1.46；95%CI，0.69至3.14），即使调整了两组之间的差异。C-T和CAZ-AVI在安全性和有效性方面没有显着差异，它们是治疗多药耐药铜绿假单胞菌感染的潜在选择。
