Optimal treatment of ceftazidime-avibactam and aztreonam-avibactam against bloodstream infections or lower respiratory tract infections caused by extensively drug-resistant or pan drug-resistant (XDR/PDR) Pseudomonas aeruginosa

نویسندگان

چکیده

Objective To evaluate the efficacy of ceftazidime-avibactam (CZA) and aztreonam-avibactam (AZA) against bloodstream infections (BSIs) or lower respiratory tract (LRTIs) – caused by extensive drug-resistant pan (XDR/PDR) Pseudomonas aeruginosa. Method The two-fold dilution method was used to determine minimum inhibitory concentrations (MICs) CZA/AZA XDR/PDR P. aeruginosa . Whole-genome sequencing analyze resistance determinants each isolate. Monte Carlo simulations (MCSs) were probability target attainment (PTA) cumulative fraction response (CFR) dosing regimen via traditional infusion (TI)/optimized two-step-administration therapy (OTAT). Results We found that may carry some rare MBLs (e.g.: IND-6, SLB-1, THIN-B). isolates producing IMP-45, VIM-1, VIM-2 inhibited AZA at a concentration 2 8 mg/L. All IND-6 plus other serine β-lactamases high-level resistant (MICs >64 mg/L). simulated regimens BSIs-causing achieved 100% PTA when MIC ≤32 Conclusion has been considered as an option for treatment VIM-2. OTAT with sufficient pharmacodynamic exposure be optimal CZA/AZA.

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ژورنال

عنوان ژورنال: Frontiers in Cellular and Infection Microbiology

سال: 2023

ISSN: ['2235-2988']

DOI: https://doi.org/10.3389/fcimb.2023.1023948