Stenotrophomonas maltophilia susceptibility to ceftazidime-avibactam combination versus ceftazidime alone - 04/05/20
Sensibilité de Stenotrophomonas maltophilia à l’association ceftazidime-avibactam versus ceftazidime seule
, C. Lemarié a, R. Chenouard a, H. Pailhoriès a, M. Kempf a, b, cBienvenue sur EM-consulte, la référence des professionnels de santé.
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Highlights |
• | Combining ceftazidime (TZ) with avibactam significantly decreases the proportion of resistant S. maltophilia isolates as compared with TZ alone. |
• | Particularly interesting results in non-cystic fibrosis patients. |
• | An additional 27.7% of susceptible isolates included in the study were obtained with ceftazidime-avibactam (CZA) versus TZ alone. |
• | CZA showed better efficacy than ticarcillin-clavulanic acid, which is considered a reference beta-lactam for the treatment of S. maltophilia infections. |
Abstract |
Objective |
To compare the minimum inhibitory concentrations (MIC) of the ceftazidime-avibactam (CZA) combination versus ceftazidime alone (TZ) for Stenotrophomonas maltophilia.
Patients and methods |
MIC comparison was performed by E-tests. We assumed that CZA was more effective in vitro than TZ alone when CZA led to a category change from “Resistant” with TZ alone to “Susceptible” or “Intermediate” with CZA, or if the MIC of CZA was at least 4-fold lower than the MIC of TZ for TZ-susceptible isolates.
Results |
For the 54 clinical isolates included in the study, CZA showed better results in terms of the proportion of susceptible isolates (66.7% vs. 38.9%, P<0.01), MIC50 (2μg/mL vs. 12μg/mL, P<0.05), and MIC distribution. According to our definition, CZA was also more effective in vitro than TZ alone for 50% of the isolates.
Conclusion |
Using CZA for empirical treatments in severe or polymicrobial infections with S. maltophilia seems appropriate.
Le texte complet de cet article est disponible en PDF.Keywords : Stenotrophomonas maltophilia, Second-generation beta-lactamase inhibitors, Multidrug resistance
Plan
Vol 50 - N° 3
P. 305-307 - mai 2020 Retour au numéro
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