Ceftazidime-Avibactam Plus Aztreonam for the Treatment of Blood Stream Infection Caused by Klebsiella pneumoniae Resistant to All Beta-Lactame/Beta-Lactamase Inhibitor Combinations
Abstract
1. Introduction
2. Results
3. Discussion
4. Materials and Methods
4.1. Outcome
4.2. Definitions
4.3. Clinical Assessment
4.4. Microbiology
4.5. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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CAZ-AVI + ATM (n = 23) | DCT (n = 22) | Control Group (n = 50) | All Patients (n = 95) | p | |
---|---|---|---|---|---|
Age (years), mean (SE) | 58 (3.3) | 66.8 (1.9) | 64 (1.8) | 63.2 (1.3) | 0.06 |
Sex (male) | 18 (78.3) | 17 (77.3) | 28 (56) | 63 (66.3) | 0.08 |
APACHE II score, mean (SE) | 17.8 (1.5) | 16.3 (1) | 15.7 (0.8) | 16.3 (0.6) | 0.36 |
SOFA score, mean (SE) | 8.6 (0.7) | 7.5 (0.5) | 7.3 (0.3) | 7.6 (0.3) | 0.12 |
Charlson Index, mean (SE) | 4.2 (0.6) | 3.9 (0.4) | 5.4 (0.5) | 4.8 (0.3) | 0.08 |
Immunosuppression | 1 (4) | 0 (0) | 3 (6) | 4 (4) | 0.50 |
Hospitalisation during the last 30 days (yes) | 16 (69.6) | 13 (59.1) | 32 (64) | 61 (64.2) | 0.33 |
Antibiotics during the last 30 days (yes) | 15 (65.2) | 13 (59.1) | 27 (54) | 55 (57.9%) | 0.40 |
CAZ-AVI + ATM (n = 23) | DCT (n = 22) | Control Group (n = 50) | All Patients (n = 95) | p | |
---|---|---|---|---|---|
WBC (109/L), mean (SE), (normal range 5–10 × 109/L) | 14.48 (1.26) | 13.07 (1.05) | 12.08 (0.8) | 12.890 (0.58) | 0.97 |
Lymphocytes (109/L), mean (SE), (normal range 1–4 × 109/L) | 1.13 (0.16) | 2.03 (0.54) | 1.09 (0.12) | 1.32 (0.15) | 0.71 |
CRP (mg/dl), mean (SE), (normal range < 1.0 mg/dl) | 9.8 (1.7) | 6.1 (1.4) | 9.1 (1.4) | 8.5 (0.9) | 0.89 |
Lactate (mmol/L), mean (SE) | 3.5 (0.9) | 1.4 (0.1) | 1.7 (0.3) | 2.1 (0.03) | 0.66 |
Total bilirubin (mg/dl), mean (SE), (normal range 0.3–1.0 mg/dl) | 1.2 (0.4) | 0.5 (0.1) | 0.7 (0.1) | 0.8 (0.1) | 0.74 |
Platelets (109/L), mean (SE), (normal range 150–400 × 109/L) | 285 (31) | 310 (31) | 255 (14) | 275 (13) | 0.32 |
INR, mean (SE) (normal ramge 0.8–1.1) | 1.4 (0.1) | 1.2 (0.04) | 1.4 (0.08) | 1.3 (0.05) | 0.63 |
Septic shock (yes) | 11 (47.8) | 15 (68.2) | 19(38) | 45 (47.4) | 0.07 |
PaO2/FiO2 ratio, mean (SE) | 240.8 (24.4) | 144 (13.2) | 197.4 (16.3) | 195.5 (11.3) | 0.01 |
Acute kidney injury (yes) | 6 (26.1) | 10 (45.5) | 14 (28) | 30 (31.6) | 0.28 |
Hemofiltration (yes) | 8 (34.8) | 9 (40.9) | 9 (18) | 26 (27.4) | 0.08 |
Active antibiotics within 24 h (yes) | 11 (47.8) | 6 (27.3) | 32 (64) | 49 (51.6) | 0.02 |
CAZ-AVI + ATM (n = 23) | DCT (n = 22) | Control Group (n = 50) | p | |
---|---|---|---|---|
Day 0 | 8 (0.8) | 8.3 (0.7) | 6.9 (0.5) | 0.26 |
Day 4 | 8.9 (1) | 7.4 (0.9) | 6.4 (0.5) | 0.045 |
Day 7 | 8.8 (1) | 7.3 (1.1) | 6.1 (0.6) | 0.06 |
CAZ-AVI + ATM (n = 23) | DCT (n = 22) | Control Group (n = 50) | p | |
---|---|---|---|---|
MV duration (days), mean (SE) | 38 (5.5) | 24 (3.7) | 34 (3.2) | 0.085 |
ICU LOS (days), mean (SE) | 47.9 (7.5) | 30.3 (3.9) | 41.7 (3.9) | 0.11 |
Mortality (%) | 13 (56.5) | 15 (68.2) | 30 (60) | 0.69 |
Non-Survivors (n = 58) | Survivors (n = 37) | p | |
---|---|---|---|
Age (years), mean (SE) | 64.8 (1.5) | 60.6 (2.5) | 0.26 |
Sex (male) | 40 (69) | 23 (62.2) | 0.51 |
APACHE II score on ICU admission, mean (SE) | 16.3 (0.7) | 16.3 (1) | 0.62 |
Charlson Index, mean (SE) | 5.2 (0.4) | 4.1 (0.4) | 0.32 |
Immunosuppression (yes) | 4 (6.9) | 0 (0) | 0.15 |
SOFA score on day of BSI, mean (SE) | 8.7 (0.5) | 5.6 (0.5) | <0.0001 |
CAZ-AVI + ATM | 13 | 10 | 0.61 |
DCT | 15 | 7 | 0.44 |
Control group | 30 | 30 | 0.83 |
Acute kidney injury (yes) on day of BSI | 22 (37.9) | 8 (21.6) | 0.12 |
PaO2/FiO2 ratio on day of BSI, mean (SE) | 158.2 (13.1) | 254.6 (16.3) | <0.0001 |
Septic shock (yes) on day of BSI | 35 (60.3) | 10 (27) | 0.0015 |
INR on day of BSI, mean (SE) | 1.3 (0.06) | 1.2 (0.03) | 0.29 |
Platelets (109/L) on day of BSI, mean (SE) | 161 (16) | 249 (17) | 0.0002 |
Lactate (mmol/L) on day of BSI, mean (SE) | 3.6 (0.5) | 1.1 (0.1) | <0.0001 |
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Mantzarlis, K.; Manoulakas, E.; Papadopoulos, D.; Katseli, K.; Makrygianni, A.; Leontopoulou, V.; Katsiafylloudis, P.; Xitsas, S.; Papamichalis, P.; Chovas, A.; et al. Ceftazidime-Avibactam Plus Aztreonam for the Treatment of Blood Stream Infection Caused by Klebsiella pneumoniae Resistant to All Beta-Lactame/Beta-Lactamase Inhibitor Combinations. Antibiotics 2025, 14, 806. https://doi.org/10.3390/antibiotics14080806
Mantzarlis K, Manoulakas E, Papadopoulos D, Katseli K, Makrygianni A, Leontopoulou V, Katsiafylloudis P, Xitsas S, Papamichalis P, Chovas A, et al. Ceftazidime-Avibactam Plus Aztreonam for the Treatment of Blood Stream Infection Caused by Klebsiella pneumoniae Resistant to All Beta-Lactame/Beta-Lactamase Inhibitor Combinations. Antibiotics. 2025; 14(8):806. https://doi.org/10.3390/antibiotics14080806
Chicago/Turabian StyleMantzarlis, Konstantinos, Efstratios Manoulakas, Dimitrios Papadopoulos, Konstantina Katseli, Athanasia Makrygianni, Vassiliki Leontopoulou, Periklis Katsiafylloudis, Stelios Xitsas, Panagiotis Papamichalis, Achilleas Chovas, and et al. 2025. "Ceftazidime-Avibactam Plus Aztreonam for the Treatment of Blood Stream Infection Caused by Klebsiella pneumoniae Resistant to All Beta-Lactame/Beta-Lactamase Inhibitor Combinations" Antibiotics 14, no. 8: 806. https://doi.org/10.3390/antibiotics14080806
APA StyleMantzarlis, K., Manoulakas, E., Papadopoulos, D., Katseli, K., Makrygianni, A., Leontopoulou, V., Katsiafylloudis, P., Xitsas, S., Papamichalis, P., Chovas, A., Makris, D., & Dimopoulos, G. (2025). Ceftazidime-Avibactam Plus Aztreonam for the Treatment of Blood Stream Infection Caused by Klebsiella pneumoniae Resistant to All Beta-Lactame/Beta-Lactamase Inhibitor Combinations. Antibiotics, 14(8), 806. https://doi.org/10.3390/antibiotics14080806