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头孢他啶/阿维巴坦对治疗复杂性尿路感染3期临床试验项目中患者尿液分离株的体外活性。

In vitro activity of ceftazidime/avibactam against urinary isolates from patients in a Phase 3 clinical trial programme for the treatment of complicated urinary tract infections.

作者信息

Stone Gregory G, Bradford Patricia A, Yates Katrina, Newell Paul

机构信息

AstraZeneca Pharmaceuticals, 35 Gatehouse Drive, Waltham, MA 02451, USA.

AstraZeneca, Alderley Park, Macclesfield, Cheshire SK10 4TG, UK.

出版信息

J Antimicrob Chemother. 2017 May 1;72(5):1396-1399. doi: 10.1093/jac/dkw561.

DOI:10.1093/jac/dkw561
PMID:28088768
Abstract

OBJECTIVES

To evaluate the in vitro activity of ceftazidime/avibactam relative to comparator agents against Gram-negative isolates from a Phase 3 clinical trial programme for complicated urinary tract infections (RECAPTURE).

METHODS

The in vitro activity of ceftazidime/avibactam was evaluated against 840 Gram-negative pathogens isolated at baseline from 1033 randomized patients in two pivotal Phase 3 clinical trials for the treatment of complicated urinary tract infections. The trials were conducted in 160 institutions from 25 countries worldwide. Susceptibility testing was performed by broth microdilution at a central laboratory according to CLSI methodologies.

RESULTS

Overall, ceftazidime/avibactam showed significant activity against the Enterobacteriaceae and Pseudomonas aeruginosa with MIC 90 values of 0.5 and 8 mg/L, respectively. Against the most common Enterobacteriaceae, MIC 90 values were 0.25 mg/L for Escherichia coli , 1 mg/L for Klebsiella pneumoniae , 0.06 mg/L for Proteus mirabilis and 2 mg/L for Enterobacter cloacae . The ceftazidime/avibactam MIC 90 for 154 ceftazidime-non-susceptible isolates of Enterobacteriaceae was 1 mg/L and the ceftazidime/avibactam MIC 90 for 15 non-susceptible isolates of P. aeruginosa was 64 mg/L. There was a significant reduction in the ceftazidime/avibactam MIC relative to ceftazidime alone for most of the Enterobacteriaceae isolates.

CONCLUSIONS

The ceftazidime/avibactam in vitro activity against these clinical urinary tract isolates demonstrates the potential utility of the drug in complicated urinary tract infections.

摘要

目的

评估头孢他啶/阿维巴坦相对于对照药物对来自一项针对复杂性尿路感染的3期临床试验项目(RECAPTURE)中革兰氏阴性分离株的体外活性。

方法

在两项用于治疗复杂性尿路感染的关键3期临床试验中,对从1033名随机分组患者基线时分离出的840株革兰氏阴性病原体评估了头孢他啶/阿维巴坦的体外活性。这些试验在全球25个国家的160个机构进行。药敏试验由中央实验室根据CLSI方法通过肉汤微量稀释法进行。

结果

总体而言,头孢他啶/阿维巴坦对肠杆菌科细菌和铜绿假单胞菌显示出显著活性,其MIC90值分别为0.5和8mg/L。对于最常见的肠杆菌科细菌,大肠杆菌的MIC90值为0.25mg/L,肺炎克雷伯菌为1mg/L,奇异变形杆菌为0.06mg/L,阴沟肠杆菌为2mg/L。154株对头孢他啶不敏感的肠杆菌科分离株的头孢他啶/阿维巴坦MIC90为1mg/L,15株对铜绿假单胞菌不敏感的分离株的头孢他啶/阿维巴坦MIC90为64mg/L。对于大多数肠杆菌科分离株,相对于单独使用头孢他啶,头孢他啶/阿维巴坦的MIC有显著降低。

结论

头孢他啶/阿维巴坦对这些临床尿路感染分离株的体外活性证明了该药物在复杂性尿路感染中的潜在效用。

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