Real-world usage, effectiveness, and microbiological features of ceftazidime-avibactam in clinical practice in China

Background Infections due to multidrug- and extensively drug-resistant bacteria can be difficult to treat and are associated with high mortality and burden of disease. Ceftazidime-avibactam (CVA) is used in patients with multidrug-resistant Gram-negative bacterial infections. Objective To describe the real-world usage, effectiveness, and antimicrobial features of CVA in clinical practice in China. Methods This multicenter, prospective observational study collected medical record data from adult patients (≥18 years) who had been hospitalized and treated with ≥1 dose of CVA. Clinical and microbiological outcomes were evaluated at the end of treatment, with clinical cure defined as resolution of infection following treatment with CVA. Results Data were obtained from 220 adult patients receiving ≥1 dose of CVA in China. Infections indicated for CVA included pneumonia (64.5%), complicated intra-abdominal infection (16.8%) and bloodstream infection (7.3%). Klebsiella pneumoniae (129/227 isolates, 56.8%) was the most commonly identified pathogen, followed by Pseudomonas aeruginosa (33 isolates, 14.5%). Of 87 K . pneumoniae isolates, 76 (87.4%) were meropenem resistant and the same proportion carried cabapenemase genes. Low levels of resistance to CVA were observed across all isolates. Three-quarters of patients received CVA as definitive therapy. Clinical cure at end of treatment was achieved in 66.4% of patients and microbiological success in 69.6% of patients. Conclusion Findings from this study provide important real-world data on treatment patterns, microbiological features, and clinical and microbiological outcomes for CVA in routine clinical practice in China.