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Di Pietrantonio M, Brescini L, Candi J, Gianluca M, Pallotta F, Mazzanti S, Mantini P, Candelaresi B, Olivieri S, Ginevri F, Cesaretti G, Castelletti S, Cocci E, Polo RG, Cerutti E, Simonetti O, Cirioni O, Tavio M, Giacometti A, Barchiesi F. Ceftazidime-Avibactam for the Treatment of Multidrug-Resistant Pathogens: A Retrospective, Single Center Study. Antibiotics (Basel) 2022; 11:antibiotics11030321. [PMID: 35326784 PMCID: PMC8944595 DOI: 10.3390/antibiotics11030321] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 12/07/2022] Open
Abstract
Background: Ceftazidime/avibactam is a new cephalosporin/beta-lactamase inhibitor combination approved in 2015 by the FDA for the treatment of complicated intra-abdominal and urinary tract infection, hospital-acquired pneumoniae and Gram-negative infections with limited treatment options. Methods: In this retrospective study, we evaluate the efficacy of ceftazidime/avibactam treatment in 81 patients with Gram-negative infection treated in our center from January 2018 to December 2019. The outcome evaluated was 30-days survival or relapse of infection after the first positive blood culture. Results: the majority of patients were 56 male (69%), with median age of 67. Charlson’s Comorbidity Index was >3 in 58 patients. In total, 46% of the patients were admitted into the medical unit, 41% in the ICU, and 14% in the surgical ward. Of the patients, 78% had nosocomial infections, and 22% had healthcare-related infections. The clinical failure rate was 35%: 13 patients died within 30 days from the onset of infection. The outcome was influenced by the clinical condition of the patients: solid organ transplantation (p = 0.003) emerged as an independent predictor of mortality; non-survival patients most frequently had pneumonia (p = 0.009) or mechanical ventilation (p = 0.049). Conclusion: Ceftazidime−avibactam showed high efficacy in infections caused by MDR Gram-negative pathogens with limited therapeutic options.
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Affiliation(s)
- Maria Di Pietrantonio
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (M.D.P.); (F.P.); (S.M.); (P.M.); (B.C.); (S.O.); (F.G.); (G.C.); (O.C.); (A.G.)
| | - Lucia Brescini
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (M.D.P.); (F.P.); (S.M.); (P.M.); (B.C.); (S.O.); (F.G.); (G.C.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Ancona, Torrette, Italy; (M.G.); (F.B.)
- Correspondence: ; Tel.: +39-071-596-3502
| | - Jennifer Candi
- Faculty of Medicine, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60126 Ancona, Torrette, Italy;
| | - Morroni Gianluca
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Ancona, Torrette, Italy; (M.G.); (F.B.)
| | - Francesco Pallotta
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (M.D.P.); (F.P.); (S.M.); (P.M.); (B.C.); (S.O.); (F.G.); (G.C.); (O.C.); (A.G.)
- Faculty of Medicine, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60126 Ancona, Torrette, Italy;
| | - Sara Mazzanti
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (M.D.P.); (F.P.); (S.M.); (P.M.); (B.C.); (S.O.); (F.G.); (G.C.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Ancona, Torrette, Italy; (M.G.); (F.B.)
| | - Paolo Mantini
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (M.D.P.); (F.P.); (S.M.); (P.M.); (B.C.); (S.O.); (F.G.); (G.C.); (O.C.); (A.G.)
- Faculty of Medicine, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60126 Ancona, Torrette, Italy;
| | - Bianca Candelaresi
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (M.D.P.); (F.P.); (S.M.); (P.M.); (B.C.); (S.O.); (F.G.); (G.C.); (O.C.); (A.G.)
- Faculty of Medicine, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60126 Ancona, Torrette, Italy;
| | - Silvia Olivieri
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (M.D.P.); (F.P.); (S.M.); (P.M.); (B.C.); (S.O.); (F.G.); (G.C.); (O.C.); (A.G.)
- Faculty of Medicine, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60126 Ancona, Torrette, Italy;
| | - Francesco Ginevri
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (M.D.P.); (F.P.); (S.M.); (P.M.); (B.C.); (S.O.); (F.G.); (G.C.); (O.C.); (A.G.)
- Faculty of Medicine, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60126 Ancona, Torrette, Italy;
| | - Giulia Cesaretti
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (M.D.P.); (F.P.); (S.M.); (P.M.); (B.C.); (S.O.); (F.G.); (G.C.); (O.C.); (A.G.)
- Faculty of Medicine, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60126 Ancona, Torrette, Italy;
| | - Sefora Castelletti
- Infectious Diseases, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (S.C.); (M.T.)
| | - Emanuele Cocci
- Hospital Pharmacy, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (E.C.); (R.G.P.)
| | - Rosaria G. Polo
- Hospital Pharmacy, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (E.C.); (R.G.P.)
| | - Elisabetta Cerutti
- Anesthesia and Transplant Surgical Intensive Care Unit, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy;
| | - Oriana Simonetti
- Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Conca 71, 60126 Ancona, Torrete, Italy;
| | - Oscar Cirioni
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (M.D.P.); (F.P.); (S.M.); (P.M.); (B.C.); (S.O.); (F.G.); (G.C.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Ancona, Torrette, Italy; (M.G.); (F.B.)
| | - Marcello Tavio
- Infectious Diseases, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (S.C.); (M.T.)
| | - Andrea Giacometti
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Ancona, Torrette, Italy; (M.D.P.); (F.P.); (S.M.); (P.M.); (B.C.); (S.O.); (F.G.); (G.C.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Ancona, Torrette, Italy; (M.G.); (F.B.)
| | - Francesco Barchiesi
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Ancona, Torrette, Italy; (M.G.); (F.B.)
- Infectious Diseases Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61122 Pesaro, Pesaro and Urbino, Italy
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Brescini L, Della Martera F, Morroni G, Mazzanti S, Di Pietrantonio M, Mantini P, Candelaresi B, Pallotta F, Olivieri S, Iencinella V, Castelletti S, Cocci E, Polo RG, Veccia S, Cirioni O, Tavio M, Giacometti A. Use of Dalbavancin in Skin, Bone and Joint Infections: A Real-Life Experience in an Italian Center. Antibiotics (Basel) 2021; 10:antibiotics10091129. [PMID: 34572711 PMCID: PMC8468778 DOI: 10.3390/antibiotics10091129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/23/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022] Open
Abstract
Dalbavancin is a lipoglycopeptide approved for the treatment of acute bacterial skin and skin structure infections (ABSSSI). The aim of the study was to evaluate the efficacy and safety in all patients who received at least one administration of dalbavancin. METHODS We carried out a retrospective study of the use of dalbavancin in 55 patients at the Azienda Ospedaliera Ospedali Riuniti Umberto I (Ancona, Italy) from February 2017 to May 2020 and compared "on label" and "off label" use of dalbavancin in ABSSSI and non-ABSSSI. RESULTS A total of 55 patients were included in the study. The median age was 61 years; 51% had ABSSSI; 24% had prosthetic joint infections, and 14% had osteomyelitis. A total of 53% received a single 1500 mg infusion of dalbavancin, and 18% received a second dose 14 days later; 24% of patients received further doses at 14-day intervals. In 91% of cases, patients achieved clinical objectives with dalbavancin: 96% of patients with ABSSSI and 69% of those with prosthetic joint infections. CONCLUSIONS Dalbavancin was shown to have an excellent tolerability profile and to be a highly successful therapeutic approach even in those cases treated "off-label".
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Affiliation(s)
- Lucia Brescini
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
- Correspondence: ; Tel.: +39-071-596-3502
| | - Filippo Della Martera
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Gianluca Morroni
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Sara Mazzanti
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Maria Di Pietrantonio
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Paolo Mantini
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Bianca Candelaresi
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Francesco Pallotta
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Silvia Olivieri
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Valentina Iencinella
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
- Infectious Diseases, Ospedali Riuniti Umberto I, ViaConca 71, 60126 Torrette, AN, Italy; (S.C.); (M.T.)
| | - Sefora Castelletti
- Infectious Diseases, Ospedali Riuniti Umberto I, ViaConca 71, 60126 Torrette, AN, Italy; (S.C.); (M.T.)
| | - Emanuele Cocci
- Hospital Pharmacy, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (E.C.); (R.G.P.)
| | - Rosaria G. Polo
- Hospital Pharmacy, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (E.C.); (R.G.P.)
| | - Salvatore Veccia
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
| | - Oscar Cirioni
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
| | - Marcello Tavio
- Infectious Diseases, Ospedali Riuniti Umberto I, ViaConca 71, 60126 Torrette, AN, Italy; (S.C.); (M.T.)
| | - Andrea Giacometti
- Infectious Diseases Clinic, Ospedali Riuniti Umberto I, Via Conca 71, 60126 Torrette, AN, Italy; (F.D.M.); (S.M.); (M.D.P.); (P.M.); (B.C.); (F.P.); (S.O.); (S.V.); (O.C.); (A.G.)
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche Medical School, Via Tronto 10/a, 60020 Torrette, AN, Italy; (G.M.); (V.I.)
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