Rates of resistance to ceftazidime-avibactam and ceftolozane-tazobactam among patients treated for multidrug-resistant Pseudomonas aeruginosa bacteremia or pneumonia

Sunish Shah; Ellen G Kline; Ghady Haidar; Kevin M Squires; Jason M Pogue; Erin K McCreary; Justin Ludwig; Lloyd G Clarke; Madison Stellfox; Daria Van Tyne; Ryan K Shields

doi:10.1093/cid/ciae332

Rates of resistance to ceftazidime-avibactam and ceftolozane-tazobactam among patients treated for multidrug-resistant Pseudomonas aeruginosa bacteremia or pneumonia

Clin Infect Dis. 2024 Jun 21:ciae332. doi: 10.1093/cid/ciae332. Online ahead of print.

Authors

Sunish Shah^{1

2}, Ellen G Kline³, Ghady Haidar³, Kevin M Squires³, Jason M Pogue⁴, Erin K McCreary³, Justin Ludwig⁵, Lloyd G Clarke^{1

2}, Madison Stellfox³, Daria Van Tyne³, Ryan K Shields^{1

3}

Affiliations

¹ Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
² Department of Pharmacy, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
³ Department of Medicine, Division of Infectious Diseases, University of Pittsburgh, Pittsburgh PA, USA.
⁴ Department of Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA.
⁵ Office of Quality and Clinical Research Innovation, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

PMID: 38902935
DOI: 10.1093/cid/ciae332

Abstract

Among consecutive patients with multidrug-resistant Pseudomonas aeruginosa bacteremia or pneumonia we found those treated with ceftazidime-avibactam were more likely to develop resistance (defined as ≥4-fold increased MIC) than those treated with ceftolozane-tazobactam (40% vs. 10%; P=0.002). Ceftazidime-avibactam resistance was associated with new mutations in ampC and efflux regulatory pathways.

Keywords: Ceftazidime-avibactam; MDR; Pseudomonas; ceftolozane-tazobactam; resistance.

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