Higher MICs (>2 mg/L) Predict 30-Day Mortality in Patients With Lower Respiratory Tract Infections Caused by Multidrug- and Extensively Drug-Resistant Pseudomonas aeruginosa Treated With Ceftolozane/Tazobactam

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dc.contributor.authorRodríguez, Olga
dc.contributor.authorPeriañez, Leonor
dc.contributor.authorOliver, Antonio
dc.contributor.authorMunita, José
dc.contributor.authorBoté, Anna
dc.contributor.authorGasch, Oriol
dc.contributor.authorNuvials, Xavier
dc.contributor.authorDinh, Aurélien
dc.contributor.authorShaw, Robert
dc.contributor.authorLomas, José
dc.contributor.authorTorres, Vicente
dc.contributor.authorCastón, Juanjo
dc.contributor.authorAraos, Rafael
dc.contributor.authorAbbo, Lilian
dc.contributor.authorRakita, Robert
dc.contributor.authorPérez, Federico
dc.contributor.authorAitken, Samuel
dc.contributor.authorArias, Cesar
dc.contributor.authorMartín, María Luisa
dc.contributor.authorColomar, Asun
dc.contributor.authorNúñez, María Belén
dc.contributor.authorMensa, Josep
dc.contributor.authorMartínez, José
dc.contributor.authorSoriano, Alex
dc.date.accessioned2022-07-07T15:30:04Z
dc.date.available2022-07-07T15:30:04Z
dc.date.issued2019
dc.description.abstractBackground: Ceftolozane/tazobactam (C/T) efficacy and safety in ventilator-associated pneumonia (VAP) is being evaluated at a double dose by several trials. This dosing is based on a pharmacokinetic (PK) model that demonstrated that 3 g q8h achieved ≥90% probability of target attainment (50% ƒT > minimal inhibitory concentration [MIC]) in plasma and epithelial lining fluid against C/T-susceptible P. aeruginosa. The aim of this study was to evaluate the efficacy of different C/T doses in patients with lower respiratory infection (LRI) due to MDR- or XDR-P. aeruginosa considering the C/T MIC. Methods: This was a multicenter retrospective study of 90 patients with LRI caused by resistant P. aeruginosa who received a standard or high dose (HDo) of C/T. Univariable and multivariable analyses were performed to identify independent predictors of 30-day mortality. Results: The median age (interquartile range) was 65 (51-74) years. Sixty-three (70%) patients had pneumonia, and 27 (30%) had tracheobronchitis. Thirty-three (36.7%) were ventilator-associated respiratory infections. The median C/T MIC (range) was 2 (0.5-4) mg/L. Fifty-four (60%) patients received HDo. Thirty-day mortality was 27.8% (25/90). Mortality was significantly lower in patients with P. aeruginosa strains with MIC ≤2 mg/L and receiving HDo compared with the groups with the same or higher MIC and dosage (16.2% vs 35.8%; P = .041). Multivariate analysis identified septic shock (P < .001), C/T MIC >2 mg/L (P = .045), and increasing Charlson Comorbidity Index (P = .019) as independent predictors of mortality. Conclusions: The effectiveness of C/T in P. aeruginosa LRI was associated with an MIC ≤2 mg/L, and the lowest mortality was observed when HDo was administered for strains with C/T MIC ≤2 mg/L. HDo was not statistically associated with a better outcome.es
dc.description.versionVersión publicadaes
dc.identifier.citationRodríguez-Núñez O, Periañez-Parraga L, Oliver A, Munita JM, Boté A, Gasch O, Nuvials X, Dinh A, Shaw R, Lomas JM, Torres V, Castón J, Araos R, Abbo LM, Rakita R, Pérez F, Aitken SL, Arias CA, Martín-Pena ML, Colomar A, Núñez MB, Mensa J, Martínez JA, Soriano A. Higher MICs (>2 mg/L) Predict 30-Day Mortality in Patients With Lower Respiratory Tract Infections Caused by Multidrug- and Extensively Drug-Resistant Pseudomonas aeruginosa Treated With Ceftolozane/Tazobactam. Open Forum Infect Dis. 2019 Sep 28;6(10):ofz416. doi: 10.1093/ofid/ofz416es
dc.identifier.urihttps://doi.org/10.1093/ofid/ofz416es
dc.identifier.urihttp://hdl.handle.net/11447/6317
dc.language.isoenes
dc.subjectPseudomonas aeruginosaes
dc.subjectCeftolozane/tazobactames
dc.subjectMultidrug-resistantes
dc.subjectpneumoniaes
dc.subjectTracheobronchitises
dc.titleHigher MICs (>2 mg/L) Predict 30-Day Mortality in Patients With Lower Respiratory Tract Infections Caused by Multidrug- and Extensively Drug-Resistant Pseudomonas aeruginosa Treated With Ceftolozane/Tazobactames
dc.typeArticlees
dcterms.sourceOpen forum infectious diseasees

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