Giaccari Luca Gregorio, Pace Maria Caterina, Passavanti Maria Beatrice, Gargano Francesca, Aurilio Caterina, Sansone Pasquale
Department of Women, Child, General and Specialistic Surgery, University of Campania "L. Vanvitelli", 80138 Naples, Italy.
Unit of Anaesthesia, Intensive Care and Pain Management, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.
Life (Basel). 2021 May 24;11(6):474. doi: 10.3390/life11060474.
Ceftolozane/tazobactam (C/T) is a β-lactam/β-lactamase inhibitor combination that mainly targets Gram-negative bacteria. The current international guidelines recommend including C/T treatment in the empirical therapy for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). (PA) is one of the most challenging Gram-negative bacteria. We conducted a systematic review of all cases reported in the literature to summarize the existing evidence.
The main electronic databases were screened to identify case reports of patients with drug-resistant PA respiratory infections treated with C/T.
A total of 22 publications were included for a total of 84 infective episodes. The clinical success rate was 72.6% across a wide range of comorbidities. The 45.8% of patients treated with C/T presented colonization by PA. C/T was well tolerated. Only six patients presented adverse events, but none had to stop treatment. The most common therapeutic regimens were 1.5 g every 8 h and 3 g every 8 h.
C/T may be a valid therapeutic option to treat multidrug-resistant (MDR), extensively drug-resistant (XDR), pandrug-resistant (PDR), and carbapenem-resistant (CR) PA infections. However, further data are necessary to define the optimal treatment dosage and duration.
头孢洛扎/他唑巴坦（C/T）是一种β-内酰胺类/β-内酰胺酶抑制剂组合，主要针对革兰氏阴性菌。当前国际指南建议在医院获得性肺炎（HAP）和呼吸机相关性肺炎（VAP）的经验性治疗中纳入C/T治疗。铜绿假单胞菌（PA）是最具挑战性的革兰氏阴性菌之一。我们对文献中报道的所有病例进行了系统综述，以总结现有证据。
筛选主要电子数据库，以识别接受C/T治疗的耐药PA呼吸道感染患者的病例报告。
共纳入22篇文献，涉及84次感染发作。在各种合并症中，临床成功率为72.6%。接受C/T治疗的患者中有45.8%出现PA定植。C/T耐受性良好。只有6名患者出现不良事件，但均无需停药。最常见的治疗方案是每8小时1.5克和每8小时3克。
C/T可能是治疗多重耐药（MDR）、广泛耐药（XDR）、全耐药（PDR）和碳青霉烯耐药（CR）PA感染的有效治疗选择。然而，需要更多数据来确定最佳治疗剂量和疗程。
