Evidence map›Paper›PMID 42919204›Full record

ArticleBMC infectious diseases2026

Ceftazidime-avibactam as a polymyxin-sparing option for multidrug-resistant Gram-negative infections in children: a real-world comparative cohort study.

Sevgi Aslan Tuncay, Gulsen Akkoc, Ezgi Celikboya, Seyhan Yilmaz, Burcu Parlak, Pinar Canizci Erdemli, Aylin Dizi Isik, Didem Buyuktas Aytac, Meryem Cagla Abaci Capar, Ahmet Furkan Eser and 3 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Sevgi Aslan TuncayDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye.
Gulsen AkkocDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye. agulsenakkoc@gmail.com.
Ezgi CelikboyaDivision of Pediatric Intensive Care Unit,Department of Pediatrics, Faculty of Medicine, Marmara University, Istanbul, Türkiye.
Seyhan YilmazDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye.
Burcu ParlakDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye.
Pinar Canizci ErdemliDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye.
Aylin Dizi IsikDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye.
Didem Buyuktas AytacDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye.
Meryem Cagla Abaci CaparDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye.
Ahmet Furkan EserDivision of Pediatric Intensive Care Unit,Department of Pediatrics, Faculty of Medicine, Marmara University, Istanbul, Türkiye.
Makbule Nilufer Yalindag OzturkDivision of Pediatric Intensive Care Unit,Department of Pediatrics, Faculty of Medicine, Marmara University, Istanbul, Türkiye.
Eda KepenekliDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye.
Sevliya Ocal DemirDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultidrug-resistant (MDR) Gram-negative infections are challenging to treat in children, and polymyxin-based regimens are limited by toxicity. We evaluated the real-world use of ceftazidime-avibactam (CZA) as a potential polymyxin-sparing option for children with MDR Gram-negative infections.

methodsWe conducted a single-center retrospective comparative cohort study at a tertiary hospital in Istanbul, Türkiye. Children aged < 18 years who received definitive therapy for microbiologically confirmed MDR Gram-negative infections between January 2022 and May 2024 were included. The primary outcome was 28-day all-cause mortality. Secondary outcomes included clinical response, documented microbiological clearance, acute kidney injury (AKI), drug-induced liver injury (DILI) and one-year all-cause mortality.

resultsForty-five children were included: 15 received CZA-based therapy and 30 received non-CZA regimens. Mechanical ventilation was required in 40/45 (88.9%) patients, reflecting a critically ill cohort. Steroid exposure within 30 days (46.7% vs. 6.7%; P = 0.003) and prior carbapenem exposure (93.3% versus 56.7%; P = 0.016) were more frequent in the CZA group. Clinical response (73.3% versus 73.3%; P = 1.000) and 28-day all-cause mortality (40.0% versus 40.0%; P = 1.000) were comparable between groups. Documented microbiological clearance, AKI and DILI did not differ significantly. Similar findings were observed in the CZA vs. meropenem plus colistin subgroup.

conclusionsCZA-based therapy showed similar observed outcomes and no clear excess toxicity signal compared with heterogeneous non-CZA regimens, despite preferential use in children with greater recent antimicrobial exposure and clinical complexity. These findings support CZA as a feasible polymyxin-sparing option in selected children.

Indexed as

Anti-Bacterial AgentsAzabicyclo CompoundsCeftazidimeDrug Resistance, Multiple, BacterialGram-Negative Bacterial InfectionsPolymyxinsAdolescentChildChild, PreschoolCohort StudiesDrug CombinationsFemaleGram-Negative BacteriaHumansInfantMaleAnti-Bacterial Agentsavibactam, ceftazidime drug combinationAzabicyclo CompoundsCeftazidimeDrug CombinationsPolymyxinsAntimicrobial stewardshipCarbapenem-resistant EnterobacteralesCeftazidime-avibactamChildrenMultidrug-resistant Gram-negative infectionsPolymyxin-sparing therapy

Identifiers

PMID42919204

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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.