Treatment of Bone Joint Infections by Ceftazidime/Avibactam and Ceftolozane/Tazobactam: A Cohort Study

J Glob Antimicrob Resist. 2021 Apr 29:S2213-7165(21)00094-1. doi: 10.1016/j.jgar.2021.04.003. Online ahead of print.

ABSTRACT

BACKGROUND: . Ceftazidime/Avibactam (C/A) and Ceftolozane/Tazobactam (C/T) are two novel antibacterial agents with a known efficacy on Gram-negative bacteria (GNB).

OBJECTIVES: . We aimed to describe the efficacy and safety of surgical management combined with C/A or C/T treatment for bone and joint infections (BJI).

PATIENTS AND METHODS: . We conducted an observational, bi-centric study of patients treated with C/A or C/T for a BJI between May 2016 and June 2019. Failure was defined as a need for an unplanned additional antibiotic treatment or orthopedic surgery or death due to the BJI until the patient's latest visit.

RESULTS: . Overall, 15 patients were included. Nine patients were treated with C/A, mainly for polymicrobial BJI due to multidrug-resistant (MDR) bacteria (Enterobacteriaceae n=7). Six patients were male; median age was 66 years-old, and median Charlson comorbidity index (CCI) was 5. It was the first septic episode on the site in 3/9 patients. Cure rate was 7/9 (median follow-up: 272 days). Two patients showed C/A-related confusion. Five patients were treated with C/T, for BJI involving MDR-Pseudomonas aeruginosa. Four patients were male; median age was 53 years-old, and median-CCI was 2. All patients had previous septic episodes on infectious site. Cure rate was 3/5 (median follow-up: 350 days). One patient was successfully treated by C/T then C/A for multistage spondylodiscitis.

CONCLUSION: . In our experience, C/A and C/T were two effective and safe options, even as salvage treatment of BJI due to MDR GNB despite the absence of label, but more data are warranted.

PMID:33933698 | DOI:10.1016/j.jgar.2021.04.003