Evidence map›Paper›PMID 32107536›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021

Pharmacoepidemiology of Ceftazidime-Avibactam Use: A Retrospective Cohort Analysis of 210 US Hospitals.

Jeffrey R Strich, Emily Ricotta, Sarah Warner, Yi Ling Lai, Cumhur Y Demirkale, Samuel F Hohmann, Chanu Rhee, Michael Klompas, Tara Palmore, John H Powers and 6 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.

  1. Pooled it
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  13. Clinical and Genomic Epidemiology ofMicrobiology spectrum · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 8 institutions in 1 country.

Jeffrey R StrichCritical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
Emily RicottaEpidemiology Unit, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Sarah WarnerCritical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
Yi Ling LaiEpidemiology Unit, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Cumhur Y DemirkaleCritical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
Samuel F HohmannVizient, Irving, Texas, USA.
Chanu RheeDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Michael KlompasDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Tara PalmoreHospital Epidemiology Service, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
John H PowersClinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc, National Cancer Institute Campus at Frederick, Frederick, Maryland, USA.
John P DekkerDepartment of Laboratory Medicine, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
Jennifer AdjemianUS Public Health Service Commissioned Corps, Rockville, Maryland, USA.
Roland MatsouakaDepartment of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA.
Christopher W WoodsSchool of Medicine, Duke University, Durham, North Carolina, USA.
Robert L DannerCritical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
Sameer S KadriCritical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
National Institutes of Health Clinical Center · USNational Institutes of Health · USClinical Research Institute · USDuke University · USHarvard Pilgrim Health Care · USHarvard University · USLeidos (United States) · USNational Institute of Allergy and Infectious Diseases · US

Funding

Application of Genomic Approaches to Bacterial Pathogenesis and Mechanisms of Antimicrobial ResistanceZIAAI001249 · NIAID · NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES · PI DEKKER, JOHN · 2019 to 2025
$13.7M
Objective Evaluation of Variation in Sepsis Incidence, Mortality, and CareK08HS025008 · AHRQ · HARVARD PILGRIM HEALTH CARE, INC. · PI RHEE, CHANU · 2017 to 2019
$450k
Preclinical and Clinical Investigations of Severe Infection and Critical Illness ZIACL008060 · CLC · CLINICAL CENTER · PI DANNER, ROBERT L · 2009 to 2025
$0k
Big Data- Epidemiology of Antimicrobial ResistanceZIACL090046 · CLC · CLINICAL CENTER · PI KADRI, SAMEER · 2017 to 2025
$0k
CCR NIH HHS HHSN261200800001CNCI NIH HHS HHSN261200800001E
6 · The paper itself

Abstract

backgroundCeftazidime-avibactam has in vitro activity against some carbapenem-resistant gram-negative infections (GNIs), and therefore may be a useful alternative to more toxic antibiotics such as colistin. Understanding ceftazidime-avibactam uptake and usage patterns would inform hospital formularies, stewardship, and antibiotic development.

methodsA retrospective cohort study assessed inpatient encounters in the Vizient database. Ceftazidime-avibactam and colistin administrations were categorized into presumed empiric (3 consecutive days of therapy or less with qualifying exclusions) versus targeted therapy (≥4 consecutive days of therapy) for presumed carbapenem-resistant GNIs. Quarterly percentage change (QPC) using modified Poisson regression and relative change in frequency of targeted ceftazidime-avibactam to colistin encounters was calculated. Factors associated with preferentially receiving targeted ceftazidime-avibactam versus colistin were identified using generalized estimating equations.

resultsBetween 2015 quarter (q) 1 and 2017q4, ceftazidime-avibactam was administered 21 215 times across 1901 encounters. Inpatient prescriptions for ceftazidime-avibactam increased from 0.44/10 000 hospitalizations in 2015q1 to 7.7/10 000 in 2017q4 (QPC, +11%; 95% CI, 10-13%; P < .01), while conversely colistin prescriptions decreased quarterly by 5% (95% CI, 4-6%; P < .01). Ceftazidime-avibactam therapy was categorized as empiric 25% of the time, targeted 65% of the time, and indeterminate 10% of the time. Patients with chronic kidney disease were twice as likely to receive targeted ceftazidime-avibactam versus colistin (RR, 2.02; 95% CI, 1.82-2.25), whereas those on dialysis were less likely to receive ceftazidime-avibactam than colistin (RR, 0.71; 95% CI, .61-.83).

conclusionsSince approval in 2015, ceftazidime-avibactam use has grown for presumed carbapenem-resistant GNIs, while colistin has correspondingly declined. Renal function drove the choice between ceftazidime-avibactam and colistin as targeted therapy.

Indexed as

Drug Resistance, Multiple, BacterialPharmacoepidemiologyAnti-Bacterial AgentsAzabicyclo Compoundsbeta-LactamasesCeftazidimeDrug CombinationsHospitalsHumansMicrobial Sensitivity TestsRetrospective StudiesAnti-Bacterial Agentsavibactam, ceftazidime drug combinationAzabicyclo Compoundsbeta-LactamasesCeftazidimeDrug Combinationscarbapenem resistanceceftazidime-avibactamnovel beta-lactamase inhibitorsram-negative resistance

Identifiers

PMID32107536
PMCPMC7884805
OpenAlexW3007092919

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.