Real-World Evidence on Use of Ceftazidime-Avibactam in the Management of Gram-Negative Infections: A Retrospective Analysis

Cureus. 2024 Sep 26;16(9):e70234. doi: 10.7759/cureus.70234. eCollection 2024 Sep.

Abstract

There is limited real-world data from India examining the treatment characteristics, safety, and efficacy of ceftazidime-avibactam against Gram-negative organisms especially multidrug-resistant pathogens including carbapenem-resistant Enterobacterales and carbapenem-resistant Pseudomonas. In this retrospective study, the real-world treatment patterns, effectiveness, and safety of ceftazidime-avibactam in treating Gram-negative infections were assessed. Data was extracted from electronic health records of adult patients admitted to the hospital with documented Gram-negative infection who had received treatment for at least 48 hours with ceftazidime-avibactam as a part of routine clinical management. Among the 189 patients, on Day 3, clinical symptom improvement was recorded in 79.6% of patients who received ceftazidime-avibactam within 72 hours of hospital admission. Clinical success was achieved in 79.5% and 76.3% of assessed patients on Day 7 and Day 14/end-of-treatment (EOT), respectively. Microbiological success was reported in 76% of patients on Day 7 and in 60.3% of patients on Day 14 or EOT. The mean treatment duration of ceftazidime-avibactam therapy was 6.92 (± 4.1) days. No new safety concerns were identified. In conclusion, this study provides real-world evidence on treatment patterns and clinical outcomes associated with ceftazidime-avibactam in India, complementing the previously reported literature. The results suggest ceftazidime-avibactam is an effective and tolerable option for the management of multidrug-resistant (MDR) Gram-negative infections in critically ill patients.

Keywords: antimicrobial therapy; ceftazidime-avibactam; clinical improvement; gram-negative organisms; microbiological success.