Infection and Drug Resistance (Apr 2023)
Ceftazidime/Avibactam for the Treatment of Carbapenem-Resistant Pseudomonas aeruginosa Infection in Lung Transplant Recipients
Abstract
Juan Chen,1,* Qiqiang Liang,1,* Shuo Ding,1 Yongshan Xu,1 Yanting Hu,1 Jingyu Chen,2,3 Man Huang1,3 1Department of General Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2Wuxi Lung Transplant Center, Wuxi People’s Hospital affiliated to Nanjing Medical University, Wuxi, Jiangsu, People’s Republic of China; 3Department of Lung Transplantation, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Man Huang, Department of General Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China, Tel/Fax +86 571 89713427, Email [email protected] Jingyu Chen, Wuxi Lung Transplant Center, Wuxi People’s Hospital affiliated to Nanjing Medical University, Wuxi, Jiangsu, People’s Republic of China, Email [email protected]: Experience of ceftazidime-avibactam (CAZ/AVI) for carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection in recipients after lung transplantation (LT) is relatively limited.Methods: A retrospective observational study was conducted on lung transplant recipients receiving CAZ/AVI therapy for CRPA infection. The primary outcomes were the 14-day and 30-day mortality. The secondary outcomes were clinical cure and microbiological cure.Results: Among 183 LT recipients, a total of 15 recipients with CRPA infection who received CAZ/AVI therapy were enrolled in this study. The mean age of recipients was 54 years and 73.3% of recipients were male. The median time from infection onset to initiation of CAZ/AVI treatment was 4 days (IQR, 3– 7) and the mean duration of CAZ/AVI therapy was 10 days. CAZ/AVI was mainly administered as monotherapy in LT recipients (80%). Among these eligible recipients, 14-day and 30-day mortality were 6.7% and 13.3%, respectively. The clinical cure and microbiological cure rates of CAZ/AVI therapy were 53.3% and 60%, respectively. Three recipients (20%) experienced recurrent infection. In addition, the mean lengths of ICU stay and hospital stay were 24 days and 35 days, respectively, among LT recipients.Conclusion: CAZ/AVI may be an alternative and promising regimen for CRPA eradiation in lung transplant recipients.Keywords: carbapenem-resistantPseudomonas aeruginosa, ceftazidime/avibactam, lung transplantation, infection, efficacy, mortality
