Volume 10, Issue 2 (2024)
IEM 2024, 10(2): 111-121 |
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Gopikrishnan N, S Nair K, Mathew E, Narasimhan D, Alagesan M. Effectiveness of Ceftazidime-Avibactam versus Colistin against Carbapenem-Resistant Enterobacteriaceae- A Retrospective Study. IEM 2024; 10 (2) :111-121
URL: http://iem.modares.ac.ir/article-4-73224-en.html
URL: http://iem.modares.ac.ir/article-4-73224-en.html
1- Junior Resident, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu
2- Assistant Professor, Department Of General Medicine, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu ,Krishnasnair@psgimsr.ac.in
3- Clinical Pharmacist, Department Of General Medicine, PSG Institute of Medical Sciences Research, Coimbatore, Tamil Nadu
4- Professor, Department Of General Medicine, PSG Institute of Medical Sciences Research, Coimbatore, Tamil Nadu
5- General Medicine, Fellowship in infectious diseases, Professor, Department Of General Medicine, PSG Institute of Medical Sciences Research, Coimbatore, Tamil Nadu
2- Assistant Professor, Department Of General Medicine, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu ,
3- Clinical Pharmacist, Department Of General Medicine, PSG Institute of Medical Sciences Research, Coimbatore, Tamil Nadu
4- Professor, Department Of General Medicine, PSG Institute of Medical Sciences Research, Coimbatore, Tamil Nadu
5- General Medicine, Fellowship in infectious diseases, Professor, Department Of General Medicine, PSG Institute of Medical Sciences Research, Coimbatore, Tamil Nadu
Abstract: (725 Views)
Background: This study compared the efficacy of ceftazidime-avibactam (CAZ-AVI) with colistin for treating carbapenem-resistant Enterobacteriaceae (CRE) infections.
Materials & Methods: This retrospective study included 120 patients with a confirmed CRE infection and information on causative bacteria and their susceptibility pattern. Patients were divided into two groups: those receiving CAZ-AVI and/or aztreonam (n=53) and those receiving colistin (n=67) for at least seven days. The colistin group was further subdivided into those who switched to CAZ-AVI due to poor outcomes. Patient data, including demographics, clinical history, microbiological data, Charlson comorbidity index, and outcomes, were collected and analyzed. Mann-Whitney U, Chi-square, and Fisher’s exact tests were used to compare the groups. P< .05 was considered statistically significant.
Findings: The findings revealed comparable clinical characteristics, there were no major differences in mean duration of hospitalization, intensive care unit (ICU) admission, and Charlson scores between the two groups. The CAZ-AVI group required a significantly longer duration of antibiotic treatment (p= .018) and more source control measures (p= .009). Klebsiella pneumoniae was the predominant causative pathogen in both groups, with NDM and OXA48 carbapenem resistance genes being the most common. Toxicity (p= .001) and mortality (p= .049) were significantly higher in the colistin group. Higher improvement was observed among the CAZ-AVI group and higher mortality among the colistin group (p= .049).
Conclusion: CAZ-AVI could serve as an alternative to colistin for treating CRE infections. Further research is necessary to confirm these findings and provide evidence-based guidelines for managing CRE infections in India.
Materials & Methods: This retrospective study included 120 patients with a confirmed CRE infection and information on causative bacteria and their susceptibility pattern. Patients were divided into two groups: those receiving CAZ-AVI and/or aztreonam (n=53) and those receiving colistin (n=67) for at least seven days. The colistin group was further subdivided into those who switched to CAZ-AVI due to poor outcomes. Patient data, including demographics, clinical history, microbiological data, Charlson comorbidity index, and outcomes, were collected and analyzed. Mann-Whitney U, Chi-square, and Fisher’s exact tests were used to compare the groups. P< .05 was considered statistically significant.
Findings: The findings revealed comparable clinical characteristics, there were no major differences in mean duration of hospitalization, intensive care unit (ICU) admission, and Charlson scores between the two groups. The CAZ-AVI group required a significantly longer duration of antibiotic treatment (p= .018) and more source control measures (p= .009). Klebsiella pneumoniae was the predominant causative pathogen in both groups, with NDM and OXA48 carbapenem resistance genes being the most common. Toxicity (p= .001) and mortality (p= .049) were significantly higher in the colistin group. Higher improvement was observed among the CAZ-AVI group and higher mortality among the colistin group (p= .049).
Conclusion: CAZ-AVI could serve as an alternative to colistin for treating CRE infections. Further research is necessary to confirm these findings and provide evidence-based guidelines for managing CRE infections in India.
Keywords: Carbapenem-resistant Enterobacteriaceae, Ceftazidime, Colistin, Drug resistance, Microbial, Outcomes
Article Type: Original Research |
Subject:
Bacteriology
Received: 2024/01/2 | Accepted: 2024/04/13 | Published: 2024/06/21
Received: 2024/01/2 | Accepted: 2024/04/13 | Published: 2024/06/21
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