Marino Andrea, Pulvirenti Sarah, Campanella Edoardo, Stracquadanio Stefano, Ceccarelli Manuela, Micali Cristina, Tina Lucia Gabriella, Di Dio Giovanna, Stefani Stefania, Cacopardo Bruno, Nunnari Giuseppe
Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy.
Antibiotics (Basel). 2023 Jul 10;12(7):1169. doi: 10.3390/antibiotics12071169.
Ceftazidime/avibactam (CAZ/AVI) is an antibiotic combination approved for the treatment of several infections caused by multi-drug resistant (MDR) Gram-negative bacteria. Neonates admitted to the Neonatal Intensive Care Unit (NICU) are at high risk of developing bacterial infections, and the choice of appropriate antibiotics is crucial. However, the use of antibiotics in neonates carries risks such as antibiotic resistance and disruption of gut microbiota. This study aimed to assess the safety and efficacy of CAZ/AVI in preterm infants admitted to the NICU. Retrospective data from preterm infants with bacteremia who received CAZ/AVI were analyzed. Clinical and microbiological responses, adverse events, and outcomes were evaluated. Eight patients were included in the study, all of whom showed clinical improvement and achieved microbiological cure with CAZ/AVI treatment. No adverse drug reactions were reported. Previous antibiotic therapies failed to improve the neonates' condition, and CAZ/AVI was initiated based on clinical deterioration and epidemiological considerations. The median duration of CAZ/AVI treatment was 14 days, and combination therapy with fosfomycin or amikacin was administered. Previous case reports have also shown positive outcomes with CAZ/AVI in neonates. However, larger trials are needed to further investigate the safety and efficacy of CAZ/AVI in this population.
头孢他啶/阿维巴坦（CAZ/AVI）是一种已获批准用于治疗由多重耐药（MDR）革兰氏阴性菌引起的多种感染的抗生素组合。入住新生儿重症监护病房（NICU）的新生儿发生细菌感染的风险很高，选择合适的抗生素至关重要。然而，在新生儿中使用抗生素存在抗生素耐药性和肠道微生物群破坏等风险。本研究旨在评估CAZ/AVI在入住NICU的早产儿中的安全性和有效性。对接受CAZ/AVI治疗的患有菌血症的早产儿的回顾性数据进行了分析。评估了临床和微生物学反应、不良事件及预后。该研究纳入了8名患者，所有患者在接受CAZ/AVI治疗后均显示临床改善并实现了微生物学治愈。未报告药物不良反应。先前的抗生素治疗未能改善新生儿的病情，基于临床恶化和流行病学考虑开始使用CAZ/AVI。CAZ/AVI治疗的中位持续时间为14天，并给予了磷霉素或阿米卡星联合治疗。先前的病例报告也显示CAZ/AVI在新生儿中取得了积极的结果。然而，需要更大规模的试验来进一步研究CAZ/AVI在该人群中的安全性和有效性。
