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We employed a counterfactual framework using inverse probability of treatment weighting (IPTW) to estimate the average treatment effect on 30-day mortality. Clinical success was further assessed using Desirability of Outcome Ranking (DOOR) analysis and partial credit scoring based on patient-perspective scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 123 included patients, 77 (62.6%) received monotherapy and 46 (37.4%) received combination therapy. The combination group presented with significantly higher baseline severity, including higher APACHE II scores and rates of septic shock. In the IPTW-adjusted analysis, 30-day survival was 73.8% (95% CI: 56\u201392%) with combination therapy compared with 60.8% (95% CI: 46.8\u201377%) with monotherapy. The survival probability ratio was 1.21 (95% CI: 0.80\u20131.45), indicating no statistically significant survival benefit. The DOOR analysis showed a 54.7% (95% CI: 48.9%\u201360.4%) probability of a more favourable outcome with combination therapy, which was not statistically significant. Mean partial credit scores did not differ significantly across scenarios prioritizing survival or adverse event avoidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cohort, C\/A-based combination therapy did not provide a significant survival advantage or an improved clinical desirability ranking compared with monotherapy, after adjusting for confounding factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10096-026-05529-x","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T14:00:02Z","timestamp":1777989602000},"page":"2541-2552","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ceftazidime-avibactam as monotherapy or in combination for targeted treatment of KPC-producing Klebsiella pneumoniae infections in ICUs: a comparative analysis through counterfactual framework and desirability of outcome ranking"],"prefix":"10.1007","volume":"45","author":[{"given":"Andrea","family":"Marino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto Enrico","family":"Maraolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Mazzitelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Oliva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Geremia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"De Vito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Cosentino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Gullotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Scaglione","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Vania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Lo Menzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Navalesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Volpicelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Fiori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Prestifilippo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Cattelan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio Maria","family":"Mastroianni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giordano","family":"Madeddu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Cacopardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Nunnari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"5529_CR1","doi-asserted-by":"publisher","unstructured":"Tamma PD, Heil EL, Justo JA, Mathers AJ, Satlin MJ, Bonomo RA (2024) Infectious Diseases Society of America 2024 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections. 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