Effectiveness of Ceftazidime-Avibactam versus Colistin against Carbapenem-Resistant Enterobacteriaceae- A Retrospective Study | ||
| Infection Epidemiology and Microbiology | ||
| Article 4, Volume 10, Issue 2, 2024, Pages 111-121 PDF (505.26 K) | ||
| Document Type: Original Research | ||
| DOI: 10.52547/iem.10.2.111 | ||
| Authors | ||
| Nilaa Gopikrishnan1; Krishna S Nair* 2; Elsa Mathew3; Denesh Narasimhan4; Murali Alagesan5 | ||
| 1Junior Resident, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu | ||
| 2Assistant Professor, Department Of General Medicine, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu | ||
| 3Clinical Pharmacist, Department Of General Medicine, PSG Institute of Medical Sciences Research, Coimbatore, Tamil Nadu | ||
| 4Professor, Department Of General Medicine, PSG Institute of Medical Sciences Research, Coimbatore, Tamil Nadu | ||
| 5General Medicine, Fellowship in infectious diseases, Professor, Department Of General Medicine, PSG Institute of Medical Sciences Research, Coimbatore, Tamil Nadu | ||
| Abstract | ||
| Background: This study compared the efficacy of ceftazidime-avibactam (CAZ-AVI) with colistin for treating carbapenem-resistant Enterobacteriaceae (CRE) infections. Materials & Methods: This retrospective study included 120 patients with a confirmed CRE infection and information on causative bacteria and their susceptibility pattern. Patients were divided into two groups: those receiving CAZ-AVI and/or aztreonam (n=53) and those receiving colistin (n=67) for at least seven days. The colistin group was further subdivided into those who switched to CAZ-AVI due to poor outcomes. Patient data, including demographics, clinical history, microbiological data, Charlson comorbidity index, and outcomes, were collected and analyzed. Mann-Whitney U, Chi-square, and Fisher’s exact tests were used to compare the groups. P< .05 was considered statistically significant. Findings: The findings revealed comparable clinical characteristics, there were no major differences in mean duration of hospitalization, intensive care unit (ICU) admission, and Charlson scores between the two groups. The CAZ-AVI group required a significantly longer duration of antibiotic treatment (p= .018) and more source control measures (p= .009). Klebsiella pneumoniae was the predominant causative pathogen in both groups, with NDM and OXA48 carbapenem resistance genes being the most common. Toxicity (p= .001) and mortality (p= .049) were significantly higher in the colistin group. Higher improvement was observed among the CAZ-AVI group and higher mortality among the colistin group (p= .049). Conclusion: CAZ-AVI could serve as an alternative to colistin for treating CRE infections. Further research is necessary to confirm these findings and provide evidence-based guidelines for managing CRE infections in India. | ||
| Keywords | ||
| Carbapenem-resistant Enterobacteriaceae; Ceftazidime; Colistin; Drug resistance; Microbial; outcomes | ||
| References | ||
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