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头孢洛扎/他唑巴坦治疗成人囊性纤维化:一项法国前瞻性队列研究的结果

Ceftolozane/Tazobactam for the Treatment of Adults With Cystic Fibrosis: Results From a French Prospective Cohort Study.

作者信息

Burgel Pierre-Régis, Bourge Xavier, Mackosso Carole, Parquin Francois

机构信息

Respiratory Medicine and National Cystic Fibrosis Reference Center, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France.

Université Paris Cité and Institut Cochin, Inserm  Paris, France.

出版信息

Open Forum Infect Dis. 2024 Aug 6;11(8):ofae391. doi: 10.1093/ofid/ofae391. eCollection 2024 Aug.

Abstract

BACKGROUND

People with cystic fibrosis (pwCF) are particularly susceptible to respiratory infections, including those caused by multidrug-resistant (MDR) pathogens. Ceftolozane/tazobactam (C/T) is an antibacterial agent combination active against MDR gram-negative bacteria that has shown promising results in isolates from pwCF. This subanalysis is the first extensive observation of real-world C/T use in pwCF.

METHODS

The multicenter observational CONDUCT study included consecutive patients, some with cystic fibrosis, who received ≥1 dose of C/T at 28 centers throughout France. Patients were treated according to hospital standards and followed up until the end of C/T treatment (EOT).

RESULTS

Among 260 patients who had received ≥1 dose of C/T, 63 were pwCF, including 12 with previous lung transplant. The median age was 34 years and 55.6% of patients were female. was the most frequently isolated pathogen (n = 40/41 [97.6%]). Most tested strains (n = 65/73 [91.5%]) and all other isolated strains (, , , and ) were susceptible to C/T. Most patients completed the treatment duration, including those with historical β-lactam hypersensitivity. Reasons for stopping treatment were planned EOT and improvement in condition; overall, 88.9% of patients (n = 56/63) experienced improvement in condition. No new safety signals were identified. Mean forced expiratory volume in 1 second improved from 1.33 L to 1.47 L before and after C/T treatment, respectively (n = 52; = .057).

CONCLUSIONS

C/T treatment was well tolerated and effective in pwCF, including those with previous β-lactam hypersensitivity.

摘要

背景

囊性纤维化患者(pwCF)特别容易受到呼吸道感染,包括由多重耐药(MDR)病原体引起的感染。头孢他啶/阿维巴坦(C/T)是一种对MDR革兰氏阴性菌有效的抗菌药物组合,在从pwCF分离出的菌株中已显示出有前景的结果。该亚分析是对pwCF中C/T实际应用的首次广泛观察。

方法

多中心观察性CONDUCT研究纳入了连续的患者,其中一些患有囊性纤维化,他们在法国各地的28个中心接受了≥1剂C/T治疗。患者按照医院标准进行治疗,并随访至C/T治疗结束(EOT)。

结果

在接受≥1剂C/T治疗的260例患者中,63例为pwCF,其中12例曾接受过肺移植。中位年龄为34岁,55.6%的患者为女性。[病原体名称]是最常分离出的病原体(n = 40/41 [97.6%])。大多数检测的[菌株名称]菌株(n = 65/73 [91.5%])以及所有其他分离出的菌株([其他菌株名称]、[其他菌株名称]、[其他菌株名称]和[其他菌株名称])对C/T敏感。大多数患者完成了治疗疗程,包括那些有既往β-内酰胺过敏史的患者。停止治疗的原因是计划中的EOT和病情改善;总体而言,88.9%的患者(n = 56/63)病情得到改善。未发现新的安全信号。C/T治疗前后1秒用力呼气容积平均分别从1.33 L提高到1.47 L(n = 52;P = 0.057)。

结论

C/T治疗在pwCF中耐受性良好且有效,包括那些有既往β-内酰胺过敏史的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cba/11303002/9f641fa44d25/ofae391f1.jpg

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