ArticleInfectious diseases and therapy2025
Comparison of Effectiveness between Ceftazidime/Avibactam and Other Active Therapies for Oxacillinase-48-Producing Carbapenem-Resistant Klebsiella pneumoniae Bacteremia in Taiwan.
Article in Infectious diseases and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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9 authors.
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Abstract
introductionOxacillinase-48 (OXA-48)-producing carbapenem-resistant Klebsiella pneumoniae (CRKP) infections have been increasingly reported in Taiwan. Real-world studies regarding effective treatments for these infections are limited, and recommendations from international guidelines are controversial. The aim of this study was to compare clinical outcomes of OXA-48-producing CRKP bacteremia between patients treated with ceftazidime/avibactam (CZA) and those receiving other active therapies.
methodsUnique adult patients with OXA-48-producing CRKP bacteremia who received CZA or other therapies in vitro for at least 3 days between June 2017 and December 2024 at Taipei Veterans General Hospital were enrolled. Clinical characteristics and outcomes were compared among the treatment groups. OXA-48 strains were detected using polymerase chain reaction (PCR) followed by Sanger sequencing.
resultsOf 45 patients included in this study, 18 were treated with CZA, and 27 were treated with other active therapies. Four patients received combination therapy. Most strains were OXA-48 producers (n = 42), and the rest were OXA-181 producers. No significant difference in 30-day mortality rate was observed between the treatment groups (22.2% versus 33.3%, p = 0.420), and even in critically ill patients (28.6% versus 43.8%, p = 0.389). Acute Physiology and Chronic Health Evaluation II (APACHE II) score (hazard ratio [HR] 1.07, 95% confidence interval [CI] 1.01-1.15, p = 0.028) was an independent risk factor for 30-day mortality, and colistin-based therapy (HR 3.02, 95% CI 1.00-9.13, p = 0.050) showed marginal significance with 30-day mortality. CZA use was not associated with 30-day mortality.
conclusionsOur findings revealed that CZA and other active therapies showed similar outcomes, but colistin-based regimens should be used cautiously.
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