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门诊环境中持续输注头孢洛扎/他唑巴坦的临床与安全性评估。

Clinical and Safety Evaluation of Continuously Infused Ceftolozane/Tazobactam in the Outpatient Setting.

作者信息

Jones Bruce M, Huelfer Kathryn, Bland Christopher M

机构信息

Infectious Diseases Clinical Pharmacy Specialist, St. Joseph's/Candler Health System Inc., Savannah, Georgia, USA.

PGY-1 Pharmacy Resident, St. Joseph's/Candler Health System, Inc., Savannah, Georgia, USA.

出版信息

Open Forum Infect Dis. 2020 Jan 12;7(2):ofaa014. doi: 10.1093/ofid/ofaa014. eCollection 2020 Feb.

Abstract

BACKGROUND

Ceftolozane/tazobactam (C/T) is a novel cephalosporin/β-lactamase inhibitor currently dosed by 8-hour intervals to treat complicated and multidrug-resistant infections in inpatients. This dosing strategy limits the ability to transition patients to outpatient antimicrobial therapy. There are limited data in the literature to support continuous infusion (CI) dosing.

METHODS

This study is a retrospective chart review of patients who received CI C/T at an infusion center part of a community health system. Patients were evaluated from August 2016 through January 2018. Patients were included in the study if they were ≥18 years old and received their entire course of C/T as a CI in the outpatient setting. Patients were excluded if they received any part of their therapy as an inpatient.

RESULTS

The primary outcome evaluated was symptom resolution. Secondary outcomes evaluated were microbiologic resolution as well as patient satisfaction. Seven patients received either 4.5 or 9 grams of continuous infusion C/T every 24 hours in the outpatient setting over the study period. For the primary outcome, 6 of 7 patients had symptom resolution. For the secondary outcomes, 3 of 3 patients had microbiologic resolution, and patient satisfaction scores were overall positive among respondents.

CONCLUSIONS

Ceftolozane/tazobactam delivered as a continuous infusion may be a safe, effective, and convenient way to treat infections caused by . This novel treatment regimen can be an option for patients to avoid hospital admission or discharge to complete therapy as an outpatient.

摘要

背景

头孢他啶/阿维巴坦(C/T)是一种新型头孢菌素/β-内酰胺酶抑制剂,目前在住院患者中每8小时给药一次,用于治疗复杂性和多重耐药感染。这种给药策略限制了将患者转为门诊抗菌治疗的能力。文献中支持持续输注(CI)给药的数据有限。

方法

本研究是对在社区卫生系统的输液中心接受CI C/T治疗的患者进行的回顾性病历审查。对2016年8月至2018年1月期间的患者进行评估。如果患者年龄≥18岁且在门诊环境中接受了整个疗程的CI C/T治疗,则纳入研究。如果患者接受了任何住院治疗,则排除在外。

结果

评估的主要结局是症状缓解。评估的次要结局是微生物学缓解以及患者满意度。在研究期间,7名患者在门诊环境中每24小时接受4.5或9克的持续输注C/T。对于主要结局,7名患者中有6名症状缓解。对于次要结局,3名患者中有3名微生物学缓解,并且受访者的患者满意度评分总体为阳性。

结论

以持续输注方式给药的头孢他啶/阿维巴坦可能是治疗由……引起的感染的一种安全、有效且方便的方法。这种新型治疗方案可以作为患者避免住院或出院后作为门诊患者完成治疗的一种选择。

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