Published in:
Open Access
11-09-2023 | Ceftazidime | Research
Ceftazidime-avibactam alone or in combination with Aztreonam versus Polymyxins in the management of carbapenem-Resistant Klebsiella pneumoniae nosocomial Infections (CAPRI study): a retrospective cohort study from South India
Authors:
Racha Amarthya Sree, Anand Gupta, Nitin Gupta, Sadhana Veturi, L. Siva Kumar Reddy, Masrath Begum, Etrouth Shravani, HariPriya Reddy Challa, Satti Santhosh Reddy, Adarsh Singamsetty, Murthy Arumilli, P. Naveen Reddy, Praveen Kumar Tirlangi
Published in:
Infection
|
Issue 2/2024
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Abstract
Introduction
Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections commonly cause hospital-acquired infections. The study aimed to compare the outcomes of CRKP infections between patients receiving ceftazidime avibactam +/− aztreonam and polymyxins in a hospital setting with a high prevalence of New Delhi Metallo Beta Lactamase production.
Methods
We conducted a retrospective cohort study from January 2020 to September 2022 in critically ill adult patients admitted to a non-COVID-19 medical intensive care unit with CRKP infection. The patients were followed up for a total of 30 days or death, whichever was later.
Results
Of a total of 106 patients included in the study, 65 patients received polymyxins and 41 patients received ceftazidime–avibactam +/− aztreonam. Higher 30-day mortality was noted in the polymyxin group (56.9% vs. 29.2%, P = 0.005). The mean time to event (mortality) in ceftazidime–avibactam +/− aztreonam was 23.9 + 1.5 days which was significantly higher compared to polymyxins (17.9 + 1.2 days, p = 0.006). On Cox regression analysis, after adjusting for the covariates, the hazard ratio for time to event with the use of polymyxin was 2.02 (95% CI: 1.03–3.9).
Conclusion
Ceftazidime–avibactam + aztreonam is possibly associated with better clinical outcomes in patients infected with CRKP.