Utilization study in real clinical practice of ceftolozane/tazobactam vs aminoglycosides and/or colistin in the treatment of multirresistant or extremely resistant Pseudomonas aeruginosa

Pinilla-Rello, A. ; Huarte-Lacunza, R. ; Magallón-Martínez, A. ; Cazorla-Poderoso, L. ; Pereira-Blanco, O. ; Pérez-Moreno, M. ; Larrodé-Leciñena, I. ; Martínez Álvarez, R. M. ; López Calleja, A. I.

Resumen: Introduction. Comparative “real life” data on the effectiveness and safety of ceftolozane/tazobactam (C/T) versus other regimens (aminoglycosides/colistin/combination), in the treatment of multi-resistant (MDR) and extremely resistant (XDR) Pseudomonas aeruginosa (PA), are needed to establish positions. Material and methods. Observational, retrospective study of patients with microbiological confirmation of MDR and XDR PA from July 2016 up to December 2018 in a tertiary hospital. Variables: age, sex, comorbidities, risk factors for multidrug resistance, variables related to infection, source of infection, microorganism and type of sample, antibiotic treatment, clinical cure, microbiological cure, recurrence, mortality on admission and 30 days post-discharge. Patients were classified according to received antibiotic treatment, C/T or aminoglycosides/colistin/combination Results. A total of 405 patients with PA MDR and XDR infection (73.1% men, mean age 63 ± 15 years) were studied. An 87.1% of PA XDR and a 12.9% MDR were observed. All patients received C/T as targeted therapy and in the amino-glycosides/colistin/combination group were 73.5%. Patients in the C/T group present worse prognostic factors: septic shock (30.0%) and catheterization (90.0%) (p<0.05). There were not statistically significant differences in microbiological cure (p=0.412), recurrence (p=0.880) and clinical cure (p=0.566). There were not statistically significant differences in mortality at admission (p=0.352) or at 30 days after discharge (p=0.231). A 17.2% of the patients with aminoglycosides/colistin/combination had acute kidney injury according to RIFLE criteria and 4.3% with C/T. Conclusions. The data obtained suggest that there have been no differences in effectiveness (clinical or microbiological cure) in favour of C/T, although, in the period studied, it was used in most cases in multitreated patients with a worse prognosis. Randomized and prospective studies would be needed to establish an adequate positioning. © The Author 2021.

Idioma: Español

DOI: 10.37201/req/006.2021

Año: 2021

Publicado en: Revista española de quimioterapia 34, 5 (2021), 441-449
ISSN: 0214-3429

Factor impacto JCR: 2.515 (2021)

Categ. JCR: PHARMACOLOGY & PHARMACY rank: 206 / 279 = 0.738 (2021) - Q3 - T3
Categ. JCR: MICROBIOLOGY rank: 116 / 138 = 0.841 (2021) - Q4 - T3

Factor impacto CITESCORE: 2.3 - Pharmacology, Toxicology and Pharmaceutics (Q3) - Medicine (Q3)

Factor impacto SCIMAGO: 0.44 - Microbiology (medical) (Q3) - Medicine (miscellaneous) (Q3)

Tipo y forma: Artículo (Versión definitiva)