Abstract Background. Experience of ceftazidime-avibactam (CAZ-AVI) use in OXA-48 producing K. pneumoniae bloodstream infections (OXA-48-Kp BSIs) is limited. We aimed to describe the clinical outcomes of OXA-48-Kp BSIs treated with CAZ-AVI in hospital settings, where OXA-48-producing K. pneumoniae is endemic. Methods. A multicenter retrospective observational study was conducted between January 2017 and September 2021. The aim of the study is to describe the clinical data that affects outcome, the 30-day mortality and relapse. The predictors of 30-day mortality are detected by using cox regression model. Results. We included 106 adults with CAZ-AVI-susceptible, carbapenem-resistant K. pneumoniae (CR-Kp) BSIs who received at least 72 hours of CAZ-AVI therapy. Mortality was found to be lower in those who started CAZ-AVI from the initial treatment compared to those who switched from colistin-based-regimen to CAZ-AVI[14.3% (n = 3/21) vs 37.7%(n = 32/85), p = 0.04].In multivariate analysis older age, having severe neutropenia were found to be significantly associated with the higher rate of mortality. Same-day CAZ-AVI start lowers mortality risk significantly.(HR:0.25, CI: 0.07–0.84, p = 0.025). Conclusions. Data of our cohort showed that CAZ-AVI monotherapy is an important treatment option in OXA-48-Kp BSIs. In addition, the study confirmed that early initiation of CAZ-AVI is more appropriate than switch to CAZ-AVI from a colistin-based-regimen.
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Mert et al. (2024) studied this question.
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