Comparison of ceftazidime-avibactam with other appropriate antimicrobial therapy for the treatment of OXA-48-or KPC-producing Enterobacterales infections in Türkiye: A multi-centre retrospective matched-cohort study

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dc.contributor.authorAslan, Abdullah Tarik
dc.contributor.authorTanriverdi, Elif Seren
dc.contributor.authorKaya, Sibel Yildiz
dc.contributor.authorDalgan, Gozde
dc.contributor.authorSaltoglu, Nese
dc.contributor.authorYilmaz, Ezgi
dc.contributor.authorCicek, Yeliz
dc.date.accessioned2026-04-04T13:35:03Z
dc.date.available2026-04-04T13:35:03Z
dc.date.issued2026
dc.departmentİnönü Üniversitesi
dc.description.abstractObjective: Due to underrepresentation of carbapenemase-producing Enterobacterales infections in randomized controlled trials with ceftazidime-avibactam (CZA) and high cost of CZA therapy, other appropriate antimicrobial therapies (OAAT) are still being used for OXA-48- or KPC-producing Enterobacterales infections in T & uuml;rkiye. Methods: We conducted a multicentre retrospective 1:1 matched cohort study of patients who received >= 48 h of CZA or OAAT for documented OXA-48- or KPC-producing Enterobacterales infections. Patients were matched based on (1) the number of days (+/- 1 d) from the infection onset to the initiation of therapy, (2) INCREMENT-CPE score (+/- 1), (3) source of infection, (4) year of infectious episode, and (5) type of causative microorganism. Results: From 5 Turkish university hospitals, 180 patients were enrolled. Baseline characteristics were all similar between treatment groups. At the time of treatment initiation, 63.9% of patients were in the intensive care unit, 35.6% had septic shock and 41.1% required mechanical ventilation support. Thirty-day mortality occurred in 35.6% (32/90) of patients treated with CZA and in 56.7% (51/90) of those receiving OAAT regimens (P = 0.004). Twenty-one-day clinical response was seen in 50% (45/90) and 26.7% (24/90) of patients receiving CZA and OAAT, respectively (P = 0.002). In multivariable logistic regression analyses, CZA treatment was associated with less likelihood of mortality (aOR = 0.37; 95% CI: 0.19-0.71; P = 0.003) and higher likelihood of 21-d clinical response (aOR = 3.32; 95% CI: 1.68-6.53; P < 0001). Conclusions: Treatment with CZA is associated with more favourable clinical outcomes in treatment of OXA-48- or KPC-producing Enterobacterales infections. A randomized controlled trial is needed to confirm these results. (c) 2025 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
dc.description.sponsorshipPfizer, USA [73487303]
dc.description.sponsorshipFunding : This study was funded by an investigator-initiated grant from Pfizer, USA (Project ID: 73487303) .
dc.identifier.doi10.1016/j.ijantimicag.2025.107650
dc.identifier.issn0924-8579
dc.identifier.issn1872-7913
dc.identifier.issue1
dc.identifier.orcid0000-0002-0449-0356
dc.identifier.orcid0000-0002-4061-2322
dc.identifier.orcid0000-0002-7844-8097
dc.identifier.orcid0000-0001-8022-7325
dc.identifier.orcid0000-0002-4181-5674
dc.identifier.orcid0000-0002-2895-0345
dc.identifier.pmid41161581
dc.identifier.scopus2-s2.0-105022795229
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1016/j.ijantimicag.2025.107650
dc.identifier.urihttps://hdl.handle.net/11616/109590
dc.identifier.volume67
dc.identifier.wosWOS:001629488300002
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier
dc.relation.ispartofInternational Journal of Antimicrobial Agents
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectCeftazidime-avibactam
dc.subjectColistin
dc.subjectMeropenem
dc.subjectOXA-48
dc.subjectKPC
dc.subjectCarbapenemases
dc.subjectMortality
dc.titleComparison of ceftazidime-avibactam with other appropriate antimicrobial therapy for the treatment of OXA-48-or KPC-producing Enterobacterales infections in Türkiye: A multi-centre retrospective matched-cohort study
dc.typeArticle

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