Ceftazidime-avibactam use for the treatment of OXA-48- and/or New Delhi metallo-β-lactamase–producing Enterobacterales in cancer patients: a retrospective observational study
Ahlam Alghamdi, Hajar AlQahtani, Sara Albilal, Maram Mater Almutairi, Nouf Alobaidallah, Linah Alghamdi, Amal Alfayez, Thamer Almangour, Ahmed Al-jedai- General Medicine
BACKGROUND:
Infection is the second-leading cause of death among cancer patients, but there have been few studies on the effectiveness of novel antimicrobial agents to treat carbapenem-resistant Enterobacterales in cancer patients.
OBJECTIVE:
Evaluate the mortality and clinical outcomes of ceftazi-dime-avibactam for OXA-48- and/or New Delhi metallo-β-lactamase (NDM)-producing Enterobacterales infection in cancer patients.
DESIGN:
Retrospective observational cohort study
SETTING:
Tertiary academic medical center in Riyadh, Saudi Arabia
SUBJECTS AND METHODS:
This study included patients who had cancer and received ceftazidime-avibactam for at least 72 hours for infections caused by OXA-48- and/or NDM-producing Enterobacterales . We excluded patients who died within 72 hours of treatment, patients with polymicrobial infections, and patients who did not receive appropriate antimicrobial therapy.
MAIN OUTCOMES AND MEASURES:
Primary outcomes were 30-day mortality and hospital mortality. Secondary outcomes included clinical cure, relapse, and reinfection.
SAMPLE SIZE:
32 cancer patients
RESULTS:
The 30-day mortality among all patients was 15/32 (47%), clinical cure was achieved in 19/32 (59%) of the patients, and the relapse and reinfection rates were 2/19 (10.5%) and 4/17 (23.5%), respectively.
CONCLUSION:
This is the largest study to evaluate clinical outcomes associated with infections caused by OXA-48- and/or NDM-producing Enterobacterales in cancer patients. The mortality rate remains high; however, ceftazidime-avibactam is an encouraging alternative for treating severe infections in cancer patients.
LIMITATIONS:
Small sample size and single center.