A descriptive pharmacokinetic/pharmacodynamic analysis of continuous infusion ceftazidime/avibactam in a case series of renal critically ill patients treated for documented carbapenem-resistant Gram-negative bloodstream infections and/or ventilator-associated pneumonia
Abstract
OBJECTIVES
To describe the pharmacokinetic/pharmacodynamic (PK/PD) behaviour of continuous infusion (CI) ceftazidime/avibactam and the microbiological outcome in a case series of renal critically ill patients treated for documented carbapenem-resistant Gram-negative (CR-GN) bloodstream infections (BSI) and/or ventilator-associated pneumonia (VAP).
METHODS
Critically ill patients with different degrees of renal function treated with CI ceftazidime-avibactam for documented CR-GN infections and underwent therapeutic drug monitoring from April 2021 to March 2022 were retrospectively assessed. Ceftazidime and avibactam concentrations were determined at steady-state, and the free fraction (fCss) was calculated. The joint PK/PD target of ceftazidime-avibactam was considered as optimal when both Css/MIC ratio for ceftazidime≥4 (equivalent to 100%fT>4xMIC) and Css/CT ratio for avibactam>1 (equivalent to 100% fT>CT of 4.0 mg/L) were simultaneously achieved (quasi-optimal if only one of the two was achieved, and suboptimal if none of the two was achieved). Relationship between ceftazidime-avibactam PK/PD targets and microbiological outcome was assessed.
RESULTS
Ten patients with documented CR-GN infections (5 BSIs, 4 VAP, and one BSI+VAP) were retrieved. The joint PK/PD targets of ceftazidime-avibactam were optimal and quasi-optimal in 8 and 2 cases, respectively. Microbiological failure occurred in two patients (one with VAP and the other with BSI+VAP), and one of these developed…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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