Rates of resistance to ceftazidime-avibactam and ceftolozane-tazobactam among patients treated for multidrug-resistant Pseudomonas aeruginosa bacteremia or pneumonia

Sunish Shah; Ellen G Kline; Ghady Haidar; Kevin M Squires; Jason M Pogue; Erin K McCreary; Justin Ludwig; Lloyd G Clarke; Madison Stellfox; Daria Van Tyne; Ryan K Shields

doi:10.1093/cid/ciae332

Rates of resistance to ceftazidime-avibactam and ceftolozane-tazobactam among patients treated for multidrug-resistant Pseudomonas aeruginosa bacteremia or pneumonia

Clin Infect Dis. 2024 Jun 21:ciae332. doi: 10.1093/cid/ciae332. Online ahead of print.

Authors

Sunish Shah^{1

2}, Ellen G Kline³, Ghady Haidar³, Kevin M Squires³, Jason M Pogue⁴, Erin K McCreary³, Justin Ludwig⁵, Lloyd G Clarke^{1

2}, Madison Stellfox³, Daria Van Tyne³, Ryan K Shields^{1

3}

Affiliations

¹ Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
² Department of Pharmacy, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
³ Department of Medicine, Division of Infectious Diseases, University of Pittsburgh, Pittsburgh PA, USA.
⁴ Department of Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA.
⁵ Office of Quality and Clinical Research Innovation, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

PMID: 38902935
DOI: 10.1093/cid/ciae332

Abstract

Among consecutive patients with multidrug-resistant Pseudomonas aeruginosa bacteremia or pneumonia we found those treated with ceftazidime-avibactam were more likely to develop resistance (defined as ≥4-fold increased MIC) than those treated with ceftolozane-tazobactam (40% vs. 10%; P=0.002). Ceftazidime-avibactam resistance was associated with new mutations in ampC and efflux regulatory pathways.

Keywords: Ceftazidime-avibactam; MDR; Pseudomonas; ceftolozane-tazobactam; resistance.

© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].