{Reference Type}: Multicenter Study
{Title}: Evaluation of clinical and microbiological factors related to mortality in patients with Gram-negative bacterial infections treated with ceftazidime-avibactam: A prospective multicentric cohort study.
{Author}: Arns B;Sorio GGL;Vieceli T;Pereira D;Celestino de Souza Â;Lamb Wink P;Paes JH;David L;Barboza F;Hickmann S;Alves G;Santos AC;da Rosa A;Duarte Alves M;Massotti Magagnin C;Gomes E;Zavascki AP;Rigatto MH;
{Journal}: J Glob Antimicrob Resist
{Volume}: 36
{Issue}: 0
{Year}: 2024 Mar 9
{Factor}: 4.349
{DOI}: 10.1016/j.jgar.2024.02.001
{Abstract}: <B>OBJECTIVE: </B>This study aimed to evaluate the clinical and microbiological risk factors associated with mortality in patients treated with ceftazidime-avibactam for carbapenem-resistant Gram-negative bacterial infections.<BR><B>METHODS: </B>This multicentric prospective cohort study included hospitalized adult patients with a microbiologically confirmed infection treated with ceftazidime-avibactam for ≥48 hours. The clinical and microbiological risk factors for 30-day mortality were evaluated using a Cox regression model.<BR><B>RESULTS: </B>Of the 193 patients evaluated from the five tertiary hospitals, 127 were included in the study. Thirty-five patients (27.6%) died within 30 days. Infections with AmpC beta-lactamase-carrying bacteria were independently related to 30-day mortality (adjusted hazard ratio [aHR] 2.49, 95% confidence interval [CI] 1.28-4.84, P < 0.01) after adjusting for time from infection to antimicrobial prescription (P = 0.04). Further, these bacterial infections were also related to higher in-hospital mortality (aHR 2.17, 95% CI 1.24-3.78, P < 0.01). Only one patient developed resistance to ceftazidime-avibactam during treatment.<BR><B>CONCLUSIONS: </B>Treatment with ceftazidime-avibactam had worse clinical outcomes in patients with infections with bacteria with chromosomally encoded AmpC beta-lactamase. However, these findings should be confirmed in future studies.