Real life experience with ceftolozane/tazobactam therapy for Pseudomonas aeruginosa bacteremia
Abstract
Ceftolozane/tazobactam is a b-lactam/b-lactamase inhibitor combination indicated for complicated urinary tract/intra-abdominal infections and pneumonia. Although promising in-vitro activity has been demonstrated against carbapenem resistant Pseudomonas aeruginosa, clinical evidence supporting efficacy of ceftolozane/tazobactam in treating bacteremia is limited. We report our experience using ceftolozane/tazobactam in P. aeruginosa bacteremia. Between January 2015 to December 2018, adults ( 18 years) with a positive blood culture for P. aeruginosa non-susceptible to meropenem at Baylor St. Luke’s Medical Center (Houston, Texas, USA) were examined. Clinical outcomes were compared for patients treated with ceftolozane/tazobactam or other agents (i.e., standard of care). Antibiotic/dosing selection was at the discretion of the attending medical teams. Appropriate empirical therapy was defined as administration within 24 h of index blood culture of an agent to which the isolate was susceptible on the final susceptibility report. The primary/secondary endpoints were 30-day and hospital (all-cause) mortality, respectively. P values of 0.05 were considered significant. Forty difficult-to-treat episodes of P. aeruginosa bacteremia were evaluated. Eleven patients (27.5%) received ceftolozane/tazobactam, while the remaining 28 patients (72.5%) received other agents (e.g., aztreonam, piperacillin/tazobactam, cefepime, meropenem, levofloxacin, amikacin, and colistin). One patient in the…
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