(265) Clinical Outcomes of Ceftazidime/Avibactam Therapy in The Treatment Carbapenem-Resistant Enterobacteriaceae (CRE) During The COVID-19 Pandemic: A Single Center Study

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 939

Presenting Author(s)

Asmaa A. Abbas
– Pharmaceutical Care Administration, Armed Forces Hospitals Southern Region, Khamis Mushait, Saudi Arabia

Co-Author(s)

Mohammad F. Zaitoun
– Pharmaceutical Care Administration, Armed forces hospitals southern region, Khamis Mushait, Saudi Arabia, Saudi Arabia
Nehad Ahmed
– Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia, Saudi Arabia
Rozan Radwan
– Pharmaceutical care department, Alnoor Specialist hospital, Makkah, Saudi Arabia, Saudi Arabia
Manal Al Gethamy
– Head, Infection control and prevention program, Alnoor specialist hospital, Makkah, Saudi Arbia, Saudi Arabia
Abdulmoeen AlQarni
– Head, Infectious disease department, Alnoor specialist hospital, Makkah, Saudi Arabia, Saudi Arabia
Lujain Babkair
– Infectious disease department, Alnoor specialist hospital, Makkah, Saudi Arabia, Saudi Arabia
Abdul Haseeb Hanif
– Clinical Pharmacy Department, College of Pharmacy, Umm AlQura University, Makkah, Saudi Arabia, Saudi Arabia

Background: The rise of carbapenem-resistant Enterobacteriaceae has become a major threat to global public health in recent years due to their limited therapeutic options. Moreover, data on the clinical outcomes for Ceftazidime/avibactam therapy for the treatment of Carbapenem-resistant Enterobacteriaceae (CRE) infections are sparse, especially during the COVID-19 pandemic.

Objectives: To evaluate the clinical outcomes of ceftazidime/avibactam use in the treatment of CRE at AL-Noor hospital in Makkah, Saudi Arabia, during the COVID-19 outbreak.

Methods: a retrospective, single-center cohort study is conducted on hospitalized adult patients who received Ceftazidime/avibactam due to CRE infection at AL-Noor Hospital between October 1, 2020, and March 27, 2022. The data utilized in this study were retrieved from the hospital's electronic medical records database. The clinical outcomes were assessed in terms of clinical cure, infectious disease-related mortality, and all-cause mortality.

Results: throughout the study period, 121 patients were prescribed ceftazidime/Avibactam. There were no significant differences in age, gender distribution, renal function categories, days of treatment, or cumulative ceftazidime/Avibactam dosage between COVID-19 (n=61) and non-COVID-19 patients (n=60). Binary logistic regression showed that the COVID-19 infection was significantly associated with ceftazidime/avibactam therapy failure (OR=5.6), infectious disease-related mortality (OR=11.88), and all-cause mortality (OR= 6.1) (p < 0.001 for all clinical outcomes). The study also revealed significantly worse clinical outcomes in the Covid-19 CRE patients with acute kidney injury (P < 0.05 for all clinical outcomes)

Conclusions: Per the study findings, COVID-19 infection and acute kidney injury are risk factors for ceftazidime/avibactam therapy failure and increased mortality among patients who have CRE isolates, larger sample size studies are required to confirm such findings.