Clinical efficacy and influencing factors of ceftazidime and avibactam monotherapy versus combination therapy in the treatment of CRGNB infection
- VernacularTitle:头孢他啶阿维巴坦单药对比联合疗法用于碳青霉烯类耐药革兰氏阴性菌感染的疗效及影响因素
- Author:
Changwei LIU
1
;
Xiaohua WANG
1
;
Hui ZHANG
2
;
Ranran WANG
1
;
Rongcheng XIAO
1
;
Ling FANG
3
Author Information
1. Dept. of Pharmacy，the First Affiliated Hospital of Anhui Medical University，Hefei 230022，China;Grade Ⅲ Pharmaceutical Chemistry Laboratory of TCM，National Administration of Traditional Chinese Medicine，Hefei 230022，China
2. Dept. of Infectious Diseases，the First Affiliated Hospital of Anhui Medical University，Hefei 230022，China
3. Dept. of Pharmacy，the First Affiliated Hospital of Anhui Medical University，Hefei 230022，China
- Publication Type:Journal Article
- Keywords:
ceftazidime and avibactam;
monotherapy
- From:
China Pharmacy
2025;36(16):2030-2034
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To compare the efficacy of ceftazidime and avibactam （CZA） monotherapy and combination therapy in the treatment of carbapenem-resistant Gram-negative bacteria （CRGNB） infections， and analyze the influencing factors. METHODS The data of patients with CRGNB infection who received CZA treatment from January 2020 to March 2025 were collected retrospectively. The patients were divided into the CZA monotherapy group （52 cases） and the CZA combination therapy group （85 cases） according to treatment regimen. The therapeutic effects of the two groups were compared， and the drug susceptibility results of isolated strains were recorded. The multivariate Logistic regression model was used to analyze the factors influencing clinical efficacy of CRGNB patients. RESULTS The bacterial clearance rate of patients was significantly higher in the CZA combination therapy group than in the CZA monotherapy group （P＝0.012）. However， when comparing the 30-day mortality rate and the clinical response rate between the two groups， no statistically significant differences were observed （P＞0.05）. Among the isolates， carbapenem-resistant Klebsiella pneumoniae had the highest sensitivity to tigecycline （87.3%） and carbapenem-resistant Pseudomonas aeruginosa showed 90.9% sensitivity to amikacin. Five isolates were resistant to CZA. The multivariate Logistic regression showed， lung infection， receiving continuous renal replacement therapy （CRRT）， and inadequate treatment courses were significantly correlated with clinical treatment failure （P＜0.05）. CONCLUSIONS For CRGNB infection， the clinical efficacy of CZA combination therapy is similar to that of monotherapy， but the combination therapy has a higher bacterial clearance rate. Lung infections， receiving CRRT and inadequate treatment courses （No. are independent risk factors for clinical treatment failure.
