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Efficacy and safety of ceftazidime-avibactam in carbapenem-resistant gram-negative bacilli sepsis according to infection site

Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To evaluate the clinical efficacy, microbiologic clearance, and safety of ceftazidime-avibactam (CAZ-AVI) in treating sepsis caused by carbapenem-resistant Gram-negative bacilli (CRO), with a focus on subgroup analyses by infection site. METHODS: This retrospective cohort study included 156 patients with CRO sepsis treated between January 2020 and January 2026. Patients were divided into an observation group (CAZ-AVI, n=74) and a control group (conventional antimicrobials, n=82). Clinical outcomes, microbiological clearance rates, 28-day mortality, and adverse events were compared. Multivariate logistic regression was performed to identify factors associated with microbial clearance and 28-day mortality. RESULTS: The clinical effective rate was significantly higher in the observation group (74.32% vs. 48.78%, P=0.001), as was the microbiological clearance rate (74.32% vs. 51.22%, P=0.003). ICU and total hospital stays were significantly shorter in the observation group (both P < 0.01). Subgroup analyses showed favorable outcomes for both pulmonary and urinary tract infections, with the urinary tract subgroup achieving 84.62% clinical efficacy. The intra-abdominal infection subgroup was not included in subgroup analysis due to an extremely small sample size. CAZ-AVI treatment was independently associated with microbial clearance (OR=3.74, 95% CI: 1.69-8.27, P=0.001). No significant difference in adverse events was observed between groups. CONCLUSION: CAZ-AVI demonstrated superior clinical efficacy and microbiological clearance compared to conventional antimicrobials in treating CRO sepsis, particularly in urinary tract infections, with favorable safety profiles. These findings support CAZ-AVI as a preferred therapeutic option and highlight the importance of infection site-guided antimicrobial strategies.
DOI: 10.62347/rcgz7850
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W7167936331
FWCI:
Cites: 1
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