{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T08:33:54Z","timestamp":1780389234423,"version":"3.54.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NextGeneration EU-MUR PNRR Extended Partnership"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the clinical usefulness of a therapeutic drug monitoring (TDM)-guided strategy for attaining an aggressive pharmacokinetic\/pharmacodynamic (PK\/PD) target of continuous infusion (CI) ceftolozane\/tazobactam monotherapy in patients having Pseudomonas aeruginosa infections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a pre-post quasi-experimental study including adult patients with documented P. aeruginosa bacteraemia and\/or pneumonia who were treated with CI ceftolozane\/tazobactam monotherapy tailored by means of a TDM-guided strategy in the period 1 November 2023 to 31 July 2024 (post-intervention phase) compared with patients receiving standard management with CI ceftolozane\/tazobactam monotherapy in the period 1 April 2022 to 31 October 2023 (pre-intervention phase). Clinical outcomes were compared between pre- and post-intervention phase. Univariate and multivariate analyses were performed for identifying variables associated with microbiological failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eighty-five patients (48 in pre- and 37 in post-intervention phase) were included. Demographics and clinical features were similar in both groups. No significant difference emerged between groups in terms of microbiological eradication (P\u200a=\u200a0.10), 30 day resistance to ceftolozane\/tazobactam (P\u200a=\u200a0.37), clinical cure (P\u200a=\u200a0.26) and 30 day mortality rate (P\u200a=\u200a0.79). All patients in the post-intervention phase attained an optimal PK\/PD target, allowing the use of a lower ceftolozane\/tazobactam CI daily dosing regimen compared with the pre-intervention phase (3.0\u2005g\/1.5\u2005g versus 6.0\u2005g\/3.0\u2005g; P\u200a=\u200a0.06). The only independent predictors of microbiological failure were difficult-to-treat resistant P. aeruginosa isolates in the pre-intervention group (OR 6.99; 95% CI 1.34\u201336.55), and a ratio of partial pressure of arterial oxygen to fraction of oxygen in the inhaled air (Pao2\/Fio2 ratio) &amp;lt;200 in the post-intervention group (OR 18.00; 95% CI 1.86\u2013174.22).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our TDM-guided strategy of CI ceftolozane\/tazobactam was cost-effective in attaining an aggressive PK\/PD target of ceftolozane against susceptible P. aeruginosa strains with lower than standard daily doses without compromising efficacy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkaf098","type":"journal-article","created":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T04:24:32Z","timestamp":1743222272000},"page":"1543-1551","source":"Crossref","is-referenced-by-count":6,"title":["A pre-post quasi-experimental study of the impact of TDM-guided aggressive pharmacokinetic\/pharmacodynamic target attainment of continuous infusion ceftolozane\/tazobactam monotherapy in treating severe <i>Pseudomonas aeruginosa<\/i> infections: a strategy useful for raising the bar?"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3018-3779","authenticated-orcid":false,"given":"Milo","family":"Gatti","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna , Bologna ,","place":["Italy"]},{"name":"Clinical Pharmacology Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Via 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