Ceftazidime prescription and antibiotic resistance patterns in a tertiary care hospital.

Ceftazidime, a third-generation cephalosporin, is effective for treating infections caused by gram-negative bacteria. However, increasing antibiotic resistance, particularly in multidrug-resistant gram-negative bacilli, complicates treatment decisions and patient outcomes. This study aimed to assess the clinical epidemiology and characteristics of patients treated with intravenous ceftazidime and clarify the drug resistance patterns of the isolated pathogens. A retrospective cross-sectional study was conducted at a tertiary care center in the West Bank between June 2021 and June 2023. The study included 558 inpatients across various departments. The data collected included patient demographics, comorbidities, indications for ceftazidime use, dosage regimens, treatment outcomes, and microbiological findings. The demographic and clinical profiles of 558 patients revealed a diverse age distribution, with 57.3% aged 19-65 years. Males constituted 53.2% of the sample. Hematological malignancies (55%) and cardiovascular diseases (32.1%) were the predominant comorbidities. Ceftazidime was predominantly used in oncology settings (68.5%), with neutropenic fever (39.6%) and pneumonia (35.7%) being the most common indications. Discharge was the most common outcome (91.6%), whereas antibiotic interventions, including upgrading therapy (19.4%), were reported. Notably, Escherichia coli was the most isolated pathogen (36.1%), with 47.2% of the isolates demonstrating resistance to ceftazidime. Solid malignancies, diabetes mellitus, and liver disease were significantly associated with poorer outcomes (p < 0.05). Neutropenic fever was linked to better outcomes, whereas pneumonia and sepsis were strongly associated with death. A total of 87.4% of patients developed sepsis or septic shock during treatment (p < 0.05). This study investigated the use of ceftazidime, especially in oncology settings, in a tertiary care hospital. The increasing resistance rate to ceftazidime-particularly among Escherichia coli and Klebsiella pneumoniae-poses a major challenge for empirical therapy and underscores the urgent need for antimicrobial stewardship in resource-limited settings. Patient age, comorbidities, and infection type significantly influence outcomes, underscoring the need for careful risk stratification. These findings highlight the importance of locally adapted treatment guidelines, routine microbiological surveillance, and further research to optimize antibiotic use and improve patient outcomes.