Retrospective Evaluation of the Use of Ceftolozane/Tazobactam at a Large Academic Medical Center. Issue 6 (November 2017)

• Record Type: Journal Article
• Authors: Sacha, Gretchen L.; Neuner, Elizabeth A.; Athans, Vasilios; Bass, Stephanie N.; Pallotta, Andrea; Rivard, Kaitlyn R.; Bauer, Seth R.; Brizendine, Kyle D.
• Is Part Of: Infectious diseases in clinical practice. Volume 25:Issue 6(2017:Nov.)
• Publication Date: 2017-11
• Subjects: resistance -- ceftolozane/tazobactam -- Pseudomonas aeruginosa; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Periodicals; Electronic journals; 616.9
• DOI: 10.1097/IPC.0000000000000553
• Languages: English
• ISSNs: 1056-9103

Abstract

Abstract : Background: Ceftolozane/tazobactam is currently Food and Drug Administration–approved for the treatment of complicated intra-abdominal and urinary tract infections; however, it is often used in clinical practice for nosocomial pneumonia, particularly due to Pseudomonas aeruginosa. Previous data in this area are limited to small case studies. Methods: This was a retrospective case series of all patients receiving ceftolozane/tazobactam for a variety of infectious indications at a large academic medical center. Results: There were 60 cases included in this evaluation. Most patients were treated for pneumonia (34 [56.7%]), followed by intra-abdominal infection (11 [18.3%]), skin and soft tissue infection (3 [5%]), primary bacteremia (4 [6.7%]), bone and joint infection (2 [3.3%]), and pleural space infection (2 [3.3%]); 12 patient encounters (20%) had a concomitant bacteremia. Most patients had P. aeruginosa isolated (86.7%): 18 (34.6%) of these were non–multidrug resistant (MDR), 21 MDR (40.4%), and 13 extensively drug resistant (25%). The overall ceftolozane/tazobactam susceptibility rate was 83% with rates of 94.1%, 94.7%, and 45.5%, respectively, for non-MDR, MDR, and extensively drug-resistant isolates. Clinical cure was achieved in 25 (64.1%), clinical failure occurred in 10 (25.6%), and clinical status was unable to be determined in 4 cases (10.3%). Ten patients died in the hospital while on ceftolozane/tazobactam. Conclusions: It seems that ceftolozane/tazobactam is a reasonable option for P. aeruginosa infections, yet prospective analyses are needed to further guide dosing recommendations and provide additional insight into patient outcomes associated with the use of this agent. Abstract : The current evaluation was a retrospective review of the clinical use of ceftolozane/tazobactam at a large academic medical center. Sixty patient cases were included, a majority of which had a pseudomonal pneumonia. The overall percent susceptibility of Pseudomonas aeruginosa to ceftolozane/tazobactam was 83%, and clinical cure was achieved in 64.1% of cases.