Effectiveness of Ceftazidime-Avibactam in Gram-Negative Nosocomial Pneumonia: A Real-World Study in India

• Published in: Curēus (Palo Alto, CA) CA), 2024-02, Vol.16 (2), p.e54443-e54443
• Main Authors: Gupta, Neha, Saseedharan, Sanjith, Paliwal, Yashesh
• Format: Article
• Language: English
• Subjects: Bacteria; Cardiovascular disease; Chronic obstructive pulmonary disease; Creatinine; Data collection; Diabetes; Gram-negative bacteria; Gram-positive bacteria; Hospitalization; Hospitals; Hypertension; Infectious Disease; Intensive care; Intubation; Kidney diseases; Mortality; Neurology; Nosocomial infections; Observational studies; Patients; Pneumonia; Pulmonology; Recovery (Medical); Sample size; Statistical power; Thyroid gland; Urine; Ventilators
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.54443

The incidences of nosocomial pneumonia in intensive care units (ICUs) in India have been reported to range from 9% to 58% and are associated with a mortality rate of 30-70%. Ceftazidime-avibactam has activity against OXA-48-like carbapenem-resistant (CRE) and has a safer adverse effect profile as compared to the nephrotoxic colistin. The current study aimed to assess the effectiveness and usage pattern of ceftazidime-avibactam in gram-negative hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in real-world settings in India. Electronic medical records of hospitalized patients in three prominent medical centers in India (Fortis Memorial Research Centre, Gurugram, S L Raheja Hospital, Mumbai, and Fortis Hospital, Anandapur, Kolkata) with nosocomial pneumonia and documented gram-negative (KP) confirmed infection were collected. This study assessed the effectiveness, usage pattern of ceftazidime-avibactam, and clinical and microbiological cure rates. Among the 116 patients included, 78.45% (91/116) showed clinical cure. Microbiological cure was observed in nine out of 13 (69.23%) patients. In the subset analysis, a clinical cure rate of 84.85% (28/33) and microbiological recovery rate of 62.50% (5/8) were observed when ceftazidime-avibactam was initiated within 72 hours of diagnosis. Ceftazidime-avibactam was administered for a mean (±SD) duration of 7.79 ± 4.43 days, with improvement in signs and symptoms reported among 91.38% (106/116). Ceftazidime-avibactam showed a susceptibility of 56% (28/56) in the study. The current study showed a better clinical and microbiological cure rate with a safer tolerability profile of ceftazidime-avibactam in carbapenem-resistant KP nosocomial pneumonia and VAP. This study has further demonstrated that ceftazidime-avibactam may be used as one of the viable treatment choices in carbapenem-resistant KP with favorable clinical outcomes.