Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Pharmacy, London Health Sciences Centre, London, Ontario, Canada.
J Glob Antimicrob Resist. 2021 Jun;25:346-350. doi: 10.1016/j.jgar.2021.03.025. Epub 2021 May 11.
Ceftolozane/tazobactam is a cephalosporin/β-lactamase inhibitor combination with activity against Gram-negative bacilli. Here we report the use of ceftolozane/tazobactam in Canada using a national registry.
The CLEAR registry uses a REDCap online survey to capture details associated with clinical use of ceftolozane/tazobactam.
Data from 51 patients treated in 2020 with ceftolozane/tazobactam are available. Infections treated included hospital-acquired bacterial pneumonia (37.3% of patients), ventilator-associated bacterial pneumonia (15.7%), bone and joint infection (11.8%), complicated intra-abdominal infection (7.8%) and complicated skin and skin-structure infection (7.8%). Moreover, 17.6% of patients had bacteraemia and 47.1% were in intensive care. Ceftolozane/tazobactam was primarily used as directed therapy for Pseudomonas aeruginosa infections (92.2% of patients). Ceftolozane/tazobactam was used because of resistance to (86.3%), failure of (11.8%) or adverse effects from (2.0%) previously prescribed antimicrobials. Ceftolozane/tazobactam susceptibility testing was performed on isolates from 88.2% of patients. Ceftolozane/tazobactam was used in combination with another antimicrobial active against Gram-negative bacilli in 39.2% of patients [aminoglycosides (15.7%), fluoroquinolones (9.8%) and colistin/polymyxin B (7.8%)]. The dosage regimen was customised in all patients based on creatinine clearance. The treatment duration was primarily >10 days (60.8% of patients), with microbiological success in 60.5% and clinical success in 64.4% of patients. Moreover, 7.8% of patients had adverse effects not requiring drug discontinuation.
In Canada, ceftolozane/tazobactam is used as directed therapy to treat a variety of severe infections caused by multidrug-resistant P. aeruginosa. It is commonly used in combination with other antimicrobials with relatively high microbiological/clinical cure rates and an excellent safety profile.
头孢洛扎他唑巴坦是一种头孢菌素/β-内酰胺酶抑制剂组合，对革兰氏阴性菌具有活性。本文报告了使用国家登记处在加拿大使用头孢洛扎他唑巴坦的情况。
CLEAR 登记处使用 REDCap 在线调查来捕获与头孢洛扎他唑巴坦临床使用相关的详细信息。
2020 年有 51 例患者接受了头孢洛扎他唑巴坦治疗，这些数据可用。治疗的感染包括医院获得性细菌性肺炎（37.3%的患者）、呼吸机相关性细菌性肺炎（15.7%）、骨和关节感染（11.8%）、复杂的腹腔内感染（7.8%）和复杂的皮肤和皮肤结构感染（7.8%）。此外，17.6%的患者有菌血症，47.1%的患者在重症监护病房。头孢洛扎他唑巴坦主要作为治疗铜绿假单胞菌感染的定向治疗药物（92.2%的患者）。使用头孢洛扎他唑巴坦是因为对（86.3%）先前规定的抗菌药物耐药、（11.8%）失败或（2.0%）不良影响。对 88.2%的患者的分离株进行了头孢洛扎他唑巴坦药敏试验。在 39.2%的患者中，头孢洛扎他唑巴坦与另一种对革兰氏阴性菌有效的抗菌药物联合使用[氨基糖苷类（15.7%）、氟喹诺酮类（9.8%）和多粘菌素 B（7.8%）]。根据肌酐清除率，所有患者的剂量方案均进行了个体化定制。治疗时间主要>10 天（60.8%的患者），微生物学治愈率为 60.5%，临床治愈率为 64.4%。此外，7.8%的患者出现无需停药的不良反应。
在加拿大，头孢洛扎他唑巴坦作为定向治疗药物用于治疗多种由耐多药铜绿假单胞菌引起的严重感染。它通常与其他具有相对较高微生物学/临床治愈率和极好安全性的抗菌药物联合使用。
